比较腹腔镜经腹腹膜前疝修补术（TAPP）和平片式无张力疝修补术治疗腹股沟疝的疗效，重点观察对术后疼痛、血清肿及复发的影响。

本研究为回顾性队列研究。纳入2019年1月至2022年6月蚌埠市第二人民医院收治的腹股沟疝患者81例。根据手术方式的不同将其分为腹腔镜组（TAPP，n=43）及开放式组（平片式无张力疝修补术，n=38）。比较2组患者手术相关指标、疼痛程度、手术前后炎性因子水平变化及术后1年并发症发生情况。

2组患者手术均获得成功。腹腔镜组手术时间长于开放式组[（61.59±10.42）min比（40.31±9.65）min，P<0.05]，术后出血量少于开放式组[（12.18±2.59）ml比（29.04±4.75）ml，P<0.05]，术后下床活动时间、术后排气时间及术后住院时间均短于开放式组[（6.75±1.18）h、（16.82±3.75）h、（4.16±0.98）d比（9.16±1.52）h、（22.04±4.17）h、（4.69±1.21）d，P均<0.05]。腹腔镜组患者术后6 h及1、3、7 d的疼痛视觉模拟评分法（VAS）评分分别为（4.53±0.61）、（3.19±0.35）、（2.46±0.31）、（1.81±0.29）分，均低于开放式组的（5.27±0.68）、（3.52±0.39）、（2.73±0.30）、（2.14±0.34）分（P均<0.001）。腹腔镜组术后C反应蛋白、白细胞介素-6及基质金属蛋白酶-9水平均低于开放式组（P<0.001）。腹腔镜组Morales分型Ⅰ、Ⅱ型血清肿分别为3、1例；开放式组Ⅰ、Ⅱ、Ⅲ、Ⅳ型血清肿分别为7、2、1、1例，腹腔镜组血清肿分型低于开放式组（Z=5.269，P=0.022）。术后1年内，腹腔镜组复发1例（2.33%），开放式组复发2例（5.26%），2组复发率比较差异无统计学意义（χ²=0.488，P>0.05）。腹腔镜组其他并发症总发生率低于开放式组（4.65%比21.05%，χ²=5.015，P=0.025）。

相比于平片式无张力疝修补术，TAPP治疗腹股沟疝可减轻患者术后疼痛，血清肿分型更低，但两种术式术后复发率相当。

To compare the effect of laparoscopic trans-abdominal preperitoneal repair (TAPP) and traditional tension-free repair in the treatment of inguinal hernia, with emphasis on the effects on postoperative pain, seroma and recurrence.

This was a retrospective cohort study. A total of 81 patients with inguinal hernia admitted to the Second People's Hospital of Bengbu between January 2019 and June 2022 were included. The patients were divided into a laparoscopic group (TAPP, n=43) and an open group (traditional tension-free repair, n=38) according to the different surgical methods. The surgical-related indicators, pain degree, changes in inflammatory factor levels before and after surgery, and the incidence of complications 1-year after surgery were compared between the two groups of patients.

The surgeries were successful in both groups. The surgical time in laparoscopic group was longer than that in open group [(61.59±10.42) min vs (40.31±9.65) min, P<0.05], and the postoperative blood loss was less than that in open group [(12.18±2.59) ml vs (29.04±4.75) ml, P<0.05], and the postoperative ambulation time, postoperative exhaust time and postoperative hospital stay were all shorter than those in open group [(6.75±1.18) h, (16.82±3.75) h, (4.16±0.98) d vs (9.16±1.52) h, (22.04±4.17) h, (4.69±1.21) d, all P<0.05]. The visual analogue scale (VAS) pain scores in laparoscopic group at 6 h, 1 d, 3 d, and 7 d after surgery were (4.53±0.61) points, (3.19±0.35) points, (2.46±0.31) points and (1.81±0.29) points, which were lower than those in open group [(5.27±0.68) points, (3.52±0.39) points, (2.73±0.30) points, (2.14±0.34) points, all P<0.001]. The levels of CRP, IL-6 and MMP-9 in laparoscopic group were lower than those in open group (all P<0.001). In laparoscopic group, there were 3 cases of Morales type Ⅰ and 1 case of type Ⅱ seroma. In open group, there were 7 cases of type Ⅰ, 2 cases of type Ⅱ, 1 case of type Ⅲ and 1 case of type Ⅳ seroma. The degree of seroma in laparoscopic group was milder than that in open group (Z=5.269, P=0.022). Recurrence occurred in 1 case (2.33%) in laparoscopic group and 2 cases (5.26%) in open group within 1 year after surgery. There was no significant difference in recurrence rate between the two groups (χ²=0.488, P>0.05). The total incidence of other complications in the laparoscopic group was lower than that in the open group (4.65% vs 21.05%; χ²=5.015, P=0.025).

Compared with open tension-free repair, TAPP can better relieve the postoperative pain and reduce the incidence of seroma, but the recurrence rates of the two types of surgery are comparable.