To compare the clinical efficacy and safety of laparoscopic tension-free hernioplasty (LTIHR) and Lichtenstein tension-free hernioplasty in the treatment of elderly patients with inguinal hernia.

A retrospective analysis was made of 251 elderly patients with inguinal hernia (aged over 60 years) admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from March 2014 to June 2017. 122 patients underwent LTIHR (laparoscopic group) and 129 patients underwent Lichtenstein tension-free hernioplasty (Lichtenstein group). The baseline data, postoperative recovery, postoperative complications and recurrence of the two groups were observed and compared.

There was no significant difference in baseline data between laparoscopic group and Lichtenstein group (P>0.05). There was no significant difference between the two groups in operation time, preoperative hospital stay, intraoperative bleeding volume, time of getting out of bed and days of hospitalization after operation (P>0.05). However, the visual analogue score (VAS) at 24 hours after operation in LTIHR group was lower than that in Lichtenstein group, and the difference was statistically significant (P<0.05). There was no significant difference between the two groups (P>0.05) in urinary retention, scrotal or labia major swelling, incision infection and groin sensory abnormality. Incision seroma and chronic pain (VAS>3) were 2, 3 cases and 11, 11 cases, respectively, and there was significant difference between the two groups (P<0.05). The follow-up time was 13 to 34 months, with median follow-up time of 18 months. There was no significant difference between the two groups in recurrence (P>0.05).

Laparoscopic tension-free inguinal hernia repair is safe and effective in the treatment of elderly inguinal hernia. Compared with Lichtenstein tension-free hernia repair, it has the advantages of less trauma, faster recovery, less incision seroma and less pain. Different surgical methods should be reasonably selected to treat inguinal hernia combined with the individual situation before operation in order to achieve better results.