Clinical analysis of biological mesh applied in laparoscopic total extraperitoneal inguinal hernia repair in adults

doi:10.3877/cma.j.issn.1674-392X.2022.05.008

Abstract

Abstract:

Objective

To investigate the early clinical safety and efficacy of biological mesh in laparoscopic total extraperitoneal repair (TEP) for adult inguinal hernia.

Methods

The clinical and follow-up data of 75 patients with inguinal hernia who underwent TEP repair with biological mesh in the Second Affiliated Hospital of Chongqing Medical University from May 2020 to January 2022 were retrospectively analyzed. The postoperative recurrence, early reactions and complications were recorded.

Results

75 patients (102 sides) with inguinal hernias were included. All operations were performed successfully and none was converted to open surgery. The average operation time for the unilateral hernia was (59.0±9.2) min, and the average operation time for the bilateral hernia was (86.4±15.0) min. 6 patients (8.0%) had postoperative moderate fever. 16 patients (18 sides, 17.6%) had moderate to severe acute pain. 11 patients (13 sides, 12.7%) had seroma. The average follow-up time was (9.7±5.7) months . The hernia recurrence occurred in 3 cases (2.9%).1 patient (1.3%) had chronic pain.

Conclusion

The application of biological mesh for TEP repair is safe and effective. The early postoperative complications of biological mesh are mainly fever, seroma, and pain. Proper suture and fixation of the mesh can reduce the recurrence.

Key words: Hernia, inguinal, Herniorrhaphy, Laparoscope, Biological mesh, Efficacy

Mingdong Wu, Junjie Liu, Wu Yu, Mingyi Zhang, Haonan Zhou, Kun Ran, Jianming Sun, Bo Tang, Yikuan Chen. Clinical analysis of biological mesh applied in laparoscopic total extraperitoneal inguinal hernia repair in adults[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(05): 525-530.

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References 24

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项目			例(%)
性别		男	64(85.3)
		女	11(14.7)
年龄(岁, ±s)			56.8±16.5
疝部位		左侧	25(33.3)
		右侧	23(30.7)
		双侧	27(36.0)
解剖分类		斜疝	64(62.7)
		直疝	33(32.4)
		股疝	2(2.0)
		复合疝	3(3.0)
腹股沟疝中华分型^[11]	Ⅰ	疝环缺损<1.5 cm	16(15.7)
	Ⅱ	疝环缺损1.5~3 cm	37(36.3)
	Ⅲ	疝环缺损>3 cm	49(48.0)

项目			例(%)
性别		男	64(85.3)
		女	11(14.7)
年龄(岁, ±s)			56.8±16.5
疝部位		左侧	25(33.3)
		右侧	23(30.7)
		双侧	27(36.0)
解剖分类		斜疝	64(62.7)
		直疝	33(32.4)
		股疝	2(2.0)
		复合疝	3(3.0)
腹股沟疝中华分型^[11]	Ⅰ	疝环缺损<1.5 cm	16(15.7)
	Ⅱ	疝环缺损1.5~3 cm	37(36.3)
	Ⅲ	疝环缺损>3 cm	49(48.0)

时间	无痛	轻度	中度
24 h	54(52.9)	38(37.3)	10(9.8)
36 h	59(57.8)	28(27.5)	15(14.7)
48 h	63(61.8)	21(20.6)	18(17.6)
72 h	80(78.4)	10(9.8)	12(11.8)
3 d~1个月	91(89.2)	7(6.9)	4(4.0)
1~3个月	95(93.1)	6(5.9)	1(1.0)
>3个月	97(95.1)	4(4.0)	1(1.0)

时间	无痛	轻度	中度
24 h	54(52.9)	38(37.3)	10(9.8)
36 h	59(57.8)	28(27.5)	15(14.7)
48 h	63(61.8)	21(20.6)	18(17.6)
72 h	80(78.4)	10(9.8)	12(11.8)
3 d~1个月	91(89.2)	7(6.9)	4(4.0)
1~3个月	95(93.1)	6(5.9)	1(1.0)
>3个月	97(95.1)	4(4.0)	1(1.0)

相关因素		赋值	例数	早期反应组(例)	无反应组(例)	χ²值	P值
性别						0.582	0.446
	男	0	64	27	37
	女	1	11	6	5
年龄						6.595	0.010
	<65岁	0	42	13	29
	≥65岁	1	33	20	13
疝类型						0.974	0.896
	斜疝	0	64	24	40
	直疝	1	33	12	21
	股疝	2	2	0	2
	复合疝	3	3	1	2
疝部位						0.182	0.670
	单侧	0	48	22	24
	双侧	1	27	11	14
缺损直径						5.862	0.015
	<3 cm	0	26	7	19
	≥3 cm	1	49	26	23
慢性阻塞性肺疾病						5.056	0.025
	无	0	59	22	37
	有	1	16	11	5
糖尿病						0.209	0.648
	无	0	63	27	36
	有	1	12	6	6
心血管疾病						0.144	0.704
	无	0	45	19	26
	有	1	30	14	16
肿瘤						0.000	1
	无	0	72	32	40
	有	1	3	1	2

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