Effect of laparoscopic transabdominal preperitoneal hernia repair on postoperative stress response and pain

doi:10.3877/cma.j.issn.1674-392X.2020.06.011

Abstract

Abstract:

Objective

To explore the effect of laparoscopic transabdominal preperitoneal hernia repair (TAPP) on postoperative complications and pain.

Methods

128 patients with inguinal hernia were divided into the TAPP group (n=64, TAPP) and the control group (n=64, tension-free hernia repair) by Random number table. The clinical indexes, levels of stress hormone, pain and complications were compared between the two groups.

Results

The time of getting out of bed, pain duration and average hospital stay in the TAPP group were lower than those in the control group (P<0.05). There was no statistically significant difference in postoperative feeding time between the two groups (P>0.05). Compared with before operation, the levels of cortisol (Cor) and aldosterone (ALD) in the two groups increased at 3 days after operation (P<0.05), while the levels of norepinephrine (NE) in the control group increased significantly (P<0.05). At 3 days after operation, the levels of Cor, NE and ALD in the TAPP group were lower than those in the control group, with statistical differences (P<0.05). Compared with those at 24 hours after operation, the scores of SF-MPQ and VAS in the two groups decreased at 72 hours after operation (P<0.05), and the scores of SF-MPQ and VAS in the TAPP group were lower than those in the control group (P<0.05).

Conclusion

TAPP is an effective method to treat inguinal hernia. Compared with tension-free hernia repair, TAPP has obvious advantages in reducing postoperative pain and complications, and has lower postoperative stress response.

Key words: Hernia, inguinal, Laparoscopic transabdominal preperitoneal hernia repair, Stress hormone, Short-form of McGill pain questionnaire

Hua Ruan, Qingping Xia, Jinping Li. Effect of laparoscopic transabdominal preperitoneal hernia repair on postoperative stress response and pain[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(06): 629-632.

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References 17

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组别	例数	术后下床时间(h)	术后进食时间(h)	术后疼痛持续时间(d)	平均住院时间(d)
观察组	64	5.7±2.1	13.1±1.7	2.1±1.1	2.3±1.5
对照组	64	10.2±3.5	14.4±3.2	4.6±0.9	4.4±1.8
t值		8.820	6.117	14.072	13.999
P值		0.000	0.117	0.000	0.000

组别	例数	术后下床时间(h)	术后进食时间(h)	术后疼痛持续时间(d)	平均住院时间(d)
观察组	64	5.7±2.1	13.1±1.7	2.1±1.1	2.3±1.5
对照组	64	10.2±3.5	14.4±3.2	4.6±0.9	4.4±1.8
t值		8.820	6.117	14.072	13.999
P值		0.000	0.117	0.000	0.000

时间	组别	例数	Cor(ng/ml)	NE(ng/ml)	ALD(ng/L)
术前	观察组	64	204.6±18.9	221.5±22.7	18.3±2.1
	对照组	64	206.8±19.5	222.4±23.1	18.4±2.4
	t值		0.648	0.222	0.251
	P值		0.518	0.824	0.802
术后3 d	观察组	64	213.1±24.6^*	225.6±20.8	22.4±3.1^*
	对照组	64	229.9±22.7^*	257.1±24.3^*	30.8±4.7^*
	t值		4.015	7.878	11.935
	P值		<0.001	<0.001	<0.001

时间	组别	例数	Cor(ng/ml)	NE(ng/ml)	ALD(ng/L)
术前	观察组	64	204.6±18.9	221.5±22.7	18.3±2.1
	对照组	64	206.8±19.5	222.4±23.1	18.4±2.4
	t值		0.648	0.222	0.251
	P值		0.518	0.824	0.802
术后3 d	观察组	64	213.1±24.6^*	225.6±20.8	22.4±3.1^*
	对照组	64	229.9±22.7^*	257.1±24.3^*	30.8±4.7^*
	t值		4.015	7.878	11.935
	P值		<0.001	<0.001	<0.001

组别	例数	VAS评分		SF-MPQ评分
组别	例数	24 h	72 h	24 h	72 h
观察组	64	3.1±1.3	2.2±0.4^*	30.4±8.4	12.3±2.5^*
对照组	64	4.9±1.1	3.3±0.9^*	79.3±7.3	65.1±6.9^*
t值		3.758	17.058	35.152	57.556
P值		0.000	0.000	0.000	0.000

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