目的

比较腹腔镜经腹腹膜前疝修补术（TAPP）与平片无张力疝修补术（Lichtenstein）在老年腹股沟疝患者中的临床疗效及安全性。

方法

回顾性分析2020 年9 月至2023 年9 月北京市石景山医院接受疝修补术的234 例老年腹股沟疝患者的临床资料。按照术式不同分为2 组，TAPP组患者接受TAPP 手术治疗（120 例），Lichtenstein 组患者接受Lichtenstein 手术治疗（114 例）。比较2 组患者的手术时间、术中出血量、术后1 周及1 个月视觉模拟评分法（VAS）评分。记录并分析术后并发症及随访12 个月期间的复发率发生情况。

结果

TAPP 组与Lichtenstein 组手术时间和术后12 个月复发率比较，差异均无统计学意义（P＞0.05）。TAPP 组在术后疼痛VAS 评分及手术并发症发生率方面均显著低于Lichtenstein 组，差异均有统计学意义（P＜0.05）。

结论

与Lichtenstein 手术相比，TAPP 在手术时间和术后复发率上表现相似，但在术后疼痛及术后并发症方面更具优势。在选择手术方法时，应综合考虑术者的腔镜技术水平、临床经验及患者的意愿，以合理选择最佳术式。

Objective

To compare the clinical efficacy and safety of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and open Lichtenstein tension-free hernioplasty in elderly patients with inguinal hernia.

Methods

A retrospective analysis was conducted on the clinical data of 234 elderly patients with inguinal hernia who underwent surgical treatment at Shijingshan Hospital in Beijing between September 2020 and September 2023.Patients were divided into two groups based on the surgical approach 120 patients received TAPP (TAPP group), and 114 patients underwent Lichtenstein repair (Lichtenstein group).The two groups were compared in terms of operative time, intraoperative blood loss, and postoperative pain assessed by the visual analog scale (VAS) at 1 week and 1 month after surgery.Postoperative complications and recurrence rates within a 12-month follow-up period were also recorded and analyzed.

Results

There were no statistically significant differences between the two groups in operative time or 12-month recurrence rates (P>0.05).However, the TAPP group showed significantly lower postoperative pain scores and a lower incidence of surgical complications compared to the Lichtenstein group (P<0.05).

Conclusion

Compared with the Lichtenstein technique, TAPP offers comparable outcomes in terms of operative time and recurrence rate, while providing significant advantages in reducing postoperative pain and complications.When selecting the surgical approach, factors such as the surgeon's proficiency in laparoscopic techniques, clinical experience, and patient preference should be comprehensively considered to determine the most appropriate method.