Analysis of clinical effect of laparoscopic total extraperitoneal inguinal hernia repair versus lichtenstein hernioplasty on patients with recurrent inguinal hernia

doi:10.3877/cma.j.issn.1674-392X.2019.04.009

Abstract

Abstract:

Objective

To analyze the effect of laparoscopic total extraperitoneal inguinal hernia repair (TEP) and Lichtenstein hernioplasty on recurrent inguinal hernia.

Methods

A retrospective analysis was conducted on 92 patients with recurrent inguinal hernia who were treated in Beijing Shijitan hospital from May 2012 to May 2017, including 42 patients with TEP as observation group and 50 patients with Lichtenstein surgery as control group. Intraoperative and postoperative complications were observed. Serum type I procollagen carboxy terminal peptide (PICP), matrix metalloproteinase inhibitor-1 (TIMP-1), matrix metalloproteinase-2 (MMP-2), matrix Metalloproteinase inhibitor-2 (TIMP-2) and type III procollagen carboxy terminal peptide (PIIINP) content before and after treatment were detected by ELISA.

Results

The intraoperative blood loss of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the time of operation, hospitalization and postoperative outpatient activity between the two groups (P>0.05). The levels of serum PICP, TIMP-1, TIMP-2 and PICP/PIIINP in the observation group were higher than those before and after treatment. The MMP-2 content was lower than that before treatment and control group, and the difference was statistically significant (P<0.05). The incidence of postoperative complications was 9.52% in the observation group and 36.00% in the control group. The difference was statistically significant (P<0.05).

Conclusion

Amount of bleeding in TEP patients with recurrent inguinal hernia is less than that in Lichtenstein. The postoperative complications are less, and the serum collagen, matrix metal inhibitory enzyme and protease content can be improved.

Key words: Hernia, inguinal, Recurrence, Herniorrhaphy, Laparoscopes, Lichtenstein

Tongsheng Wang, Hong Gao, Lei Ding, Aimin Zhao, Wenxia Li, Kai Li, Yan Wang. Analysis of clinical effect of laparoscopic total extraperitoneal inguinal hernia repair versus lichtenstein hernioplasty on patients with recurrent inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(04): 318-321.

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References 18

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组别	例数	男性/女性(例)	体质量指数(kg/m²,±s)	年龄(岁,±s)	原手术方式(例)		疝分型(例)
组别	例数	男性/女性(例)	体质量指数(kg/m²,±s)	年龄(岁,±s)	无张力疝修补术	传统手术	斜直疝	复合疝
试验组	42	39/3	22.81±2.74	62.51±4.05	15	27	23	19
对照组	50	46/4	23.10±2.86	62.91±4.18	16	34	27	23
检验值	?	0.106	0.494	0.464	0.271		0.086
P值	?	>0.05	>0.05	>0.05	>0.05		>0.05

组别	例数	男性/女性(例)	体质量指数(kg/m²,±s)	年龄(岁,±s)	原手术方式(例)		疝分型(例)
组别	例数	男性/女性(例)	体质量指数(kg/m²,±s)	年龄(岁,±s)	无张力疝修补术	传统手术	斜直疝	复合疝
试验组	42	39/3	22.81±2.74	62.51±4.05	15	27	23	19
对照组	50	46/4	23.10±2.86	62.91±4.18	16	34	27	23
检验值	?	0.106	0.494	0.464	0.271		0.086
P值	?	>0.05	>0.05	>0.05	>0.05		>0.05

组别	例数	术中出血量(ml)	手术时间(min)	住院时间(d)	术后下床活动时间(d)
试验组	42	8.61±2.10	53.19±4.08	4.87±0.41	1.14±0.29
对照组	50	24.06±2.38	61.27±4.38	5.68±0.46	1.65±0.31
P值	?	<0.05	>0.05	>0.05	>0.05

组别	例数	术中出血量(ml)	手术时间(min)	住院时间(d)	术后下床活动时间(d)
试验组	42	8.61±2.10	53.19±4.08	4.87±0.41	1.14±0.29
对照组	50	24.06±2.38	61.27±4.38	5.68±0.46	1.65±0.31
P值	?	<0.05	>0.05	>0.05	>0.05

组别	?	例数	PⅢNP(ng/L)	PⅠCP(ng/L)	PⅠCP/PⅢNP	TIMP-1(μg/dl)	TIMP-2(μg/dl)	MMP-2(μg/dl)
试验组	治疗前	42	2.31±0.63	51.07±8.22	25.19±3.07	12.45±2.84	7.83±1.09	22.69±4.62
?	治疗后	42	2.17±0.66	63.10±8.17^ab	39.17±3.65^ab	18.06±2.74^ab	13.26±1.53^ab	14.75±4.38^ab
对照组	治疗前	50	2.30±0.60	50.97±8.15	25.63±3.27	12.19±2.76	7.94±1.16	22.10±4.53
?	治疗后	50	2.20±0.64	56.83±8.41^a	31.08±3.72^a	13.56±2.59	8.08±1.20	18.06±4.39^a

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