Application of sectional anatomy in laparoscopic trans-abdominal preperitoneal hernia repair

doi:10.3877/cma.j.issn.1674-392X.2022.03.016

Abstract

Abstract:

Objective

To explore the application of sectional anatomy for trans-abdominal preperitoneal hernia repair (TAPP).

Methods

Fifty patients with inguinal hernia admitted to the First Affiliated Hospital of Yangtze University Jingzhou First People's Hospital from August 2018 to January 2020 were selected and divided into the control group and the observation group by the random number table method, with 25 patients in each group. The control group was treated with conventional TAPP, while the observation group was treated with TAPP combined with sectional anatomy. Surgical indicators (intraoperative blood loss, operation time and hospitalization time), visual analogue scale (VAS) score, complications (seroma, damage of blood vessels on the surface of bladder, the injury of peritoneal and recurrence), and the quality of life [including 8 dimensions: physiological function (PF), role physical (RP), body pain (BP), general health (GH), vitality (VT), social function (SF), role emotional (RE), and mental health (MH)] of the patients in the two groups were compared.

Results

The intraoperative blood loss and length of hospitalization time in the observation group were significantly lower than those in the control group (P<0.05), and there was no significant difference in operation time between the two groups (P>0.05). The VAS scores in the observation group on the 1st and 5th day after the surgery were significantly lower than those in the control group (P<0.05). There was no statistically significant difference in the incidence of damage of blood vessels on the surface of bladder and recurrence between the observation group and the control group (P>0.05), and the incidence of seroma and peritoneal damage in the observation group was significantly lower than that in the control group (P<0.05). The 8 dimensions quality of life scores of PF, RP, BP, GH, VT, SF, RE and MH in the observation group were significantly higher than those in the control group (P<0.05).

Conclusion

The application of sectional anatomy technique combined with TAPP in the treatment of inguinal hernia has a significant effect, which can reduce the incidence of complications and the pain of patients, and improve their quality of life.

Key words: Hernia, inguinal, Laparoscopes, Herniorrhaphy, Sectional anatomy

Yingquan Tang, Jian Li, Jianxing Zhang, Yingjun Li, Jinjian Xiang. Application of sectional anatomy in laparoscopic trans-abdominal preperitoneal hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(03): 317-320.

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References 16

[1]	钱海权, 倪睿, 陈申思, 等. 经前入路腹膜前修补术与3D-MAX补片腹腔镜下经腹膜前腹股沟疝修补术的疗效比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(5): 549-552.
[2]	HerniaSurge Group. International guidelines for groin hernia management[J]. Hernia, 2018, 22(1): 1-165.
[3]	Gutlic N, Gutlic A, Petersson U, et al. Randomized clinical trial comparing total extraperitoneal with Lichtenstein inguinal hernia repair(TEPLICH trial)[J]. Br J Surg, 2019, 106(7): 845-855.
[4]	Aghayeva A, Benlice C, Bilgin IA, et al. Laparoscopic totally extraperitoneal vs robotic transabdominal preperitoneal inguinal hernia repair: assessment of short- and long-term outcomes[J]. Int J Med Robot, 2020, 16(4): e2111-e2116.
[5]	中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J]. 中国普通外科杂志, 2018, 27(7): 803-807.
[6]	唐健雄, 李绍杰. 我国疝与腹壁外科发展和在新世纪创新挑战[J]. 中国实用外科杂志, 2020, 40(1): 89-92.
[7]	Köckerling F. TEP for elective primary unilateral inguinal hernia repair in men: what do we know?[J]. Hernia, 2019, 23(3): 439-459.
[8]	居建明, 于国锋. 腹膜前引流对腹腔镜经腹腹膜前疝修补术患者术后血肿及血清肿的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(5): 493-496.
[9]	Thiyagarajan S, Velraj J, Hussain Ahmed MI, et al. Subarachnoid block with continuous TAP catheter analgesia produces less chronic pain and better functional outcome after inguinal hernioplasty: a randomized controlled observer-blinded study[J]. Reg Anesth Pain Med, 2019, 44(2): 228-233.
[10]	高大爽, 项本宏. 腹腔镜经腹腹膜前疝修补术治疗成人腹股沟疝的临床疗效及术后并发症的危险因素分析[J]. 腹腔镜外科杂志, 2020, 25(7): 492-496, 500.
[11]	Köckerling F, Bittner R, Kuthe A, et al. TEP or TAPP for recurrent inguinal hernia repair-register-based comparison of the outcome[J]. Surg Endosc, 2017, 31(10): 3872-3882.
[12]	李胜君, 祁燕红. 腹腔镜经腹腹膜前疝修补术与完全腹膜外疝修补术的疗效对比[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(3): 207-210.
[13]	智永宏, 郝永胜, 霍瑞麟. 腹腔镜经腹腹膜前疝修补术与开放式腹膜前间隙疝修补术的临床疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(4): 293-296.
[14]	Koning GG, Andeweg CS, Keus F, et al. The transrectus sheath preperitoneal mesh repair for inguinal hernia: technique, rationale, and results of the first 50 cases[J]. Hernia, 2012, 16(3): 295-299.
[15]	Stewart AL, Hays RD, Ware JE Jr. The MOS short-form general health survey. Reliability and validity in a patient population[J]. Med Care, 1988, 26(7): 724-735.
[16]	Mohamed Z, Mohamed E. Impact of mesh fixation vs non-fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair on chronic groin pain and quality of life: a prospective randomized study[J]. Egyptian J Surg, 2020, 39(3): 574-581.

组别	例数	术中出血量(ml)	手术时间(min)	住院时间(d)
对照组	25	12.16±0.43	43.42±4.91	6.19±0.64
观察组	25	10.73±0.57	45.83±4.72	5.36±0.33
t值		10.014	1.769	5.763
P值		<0.001	0.083	<0.001

组别	例数	术中出血量(ml)	手术时间(min)	住院时间(d)
对照组	25	12.16±0.43	43.42±4.91	6.19±0.64
观察组	25	10.73±0.57	45.83±4.72	5.36±0.33
t值		10.014	1.769	5.763
P值		<0.001	0.083	<0.001

组别	例数	术后1 d	术后5 d
对照组	25	5.48±0.63	2.83±0.59
观察组	25	4.62±0.29	1.02±0.37
t值		6.200	12.995
P值		<0.001	<0.001

组别	例数	术后1 d	术后5 d
对照组	25	5.48±0.63	2.83±0.59
观察组	25	4.62±0.29	1.02±0.37
t值		6.200	12.995
P值		<0.001	<0.001

组别	例数	血清肿	膀胱表面血管损伤	腹膜破损	复发
对照组	25	9(36.00)	3(12.00)	8(32.00)	1(4.00)
观察组	25	2(8.00)	1(4.00)	2(8.00)	1(4.00)
χ²值		5.711	0.272	4.50	0.521
P值		0.017	0.602	0.034	0.470

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