To explore the difference in therapeutic effect of transabdominal preperitoneal hernia repair (TAPP), laparoscopic total extraperitoneal hernia repair (TEP), and mesh plug tension-free hernia repair on inguinal hernia patients.

90 patients with inguinal hernias diagnosed and treated in the General Surgery Department of Xuancheng People's Hospital from June 2019 to June 2022 were selected as the research subjects. According to the random number table method, they were divided into three groups: the open group (hernia ring filling for tension-free hernia repair), the TAPP group (transabdominal preperitoneal hernia repair), and the TEP group (total extraperitoneal hernia repair), with 30 cases in each group. The three groups were compared in terms of operation-related indicators (operation time, blood loss, postoperative ambulation time, anal exhaust time, total medical expenses), pain severity (visual analogue scale was used to evaluate pain at 6 h, 24 h, and 1 month after operation). The serum inflammatory response indexes [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6)] before and after surgery, as well as the incidence of complications (urinary retention, seroma, wound infection, abdominal distension, recurrence) within 3 months of surgery, were measured.

The blood loss and anal exhaust time in the open group were higher than those in the TAPP group and TEP group (P<0.05), and there was no significant difference between TAPP group and TEP group (P>0.05). The time of postoperative ambulation in open group >TAPP group >TEP group (P<0.05). The operation time of open group was less than that of TAPP group and TEP group (P<0.05), and there was no significant difference between TAPP group and TEP group (P>0.05). The total medical expenses of open group <TEP group <TAPP group (P<0.05). There were significant differences in visual analogue scale (VAS) scores between the three groups at 6 h and 24 h after operation (P<0.05). At 6 h after operation, TEP group was lower than TAPP group and open group (P<0.05). At 24 h after operation, TAPP group and TEP group were lower than open group (P<0.05). There was no significant difference among the three groups at 1 month after operation (P>0.05). There was no significant difference in CRP, TNF-α and IL-6 among the three groups before operation (P>0.05). At 48 hours after operation, the differences among the three groups were statistically significant (P<0.05), CRP in TEP group <TAPP group <open group (P<0.05). The levels of TNF-α and IL-6 in TAPP group and TEP group were lower than those in open group (P<0.05). There was a significant difference in the incidence of complications within 3 months after operation among the three groups (P<0.05), and the incidence of complications in the TAPP and TEP groups was lower than that in the open group (P<0.05).

Each of the three methods has its own advantages in the treatment of inguinal hernia, and it is necessary to choose according to the patient's condition in clinical work.