Effect of tension-free hernia repair in the treatment of patients with chronic renal failure complicated with inguinal hernia

doi:10.3877/cma.j.issn.1674-392X.2024.05.012

Abstract

Abstract:

Objective

To observe the effect of tension-free hernia repair in the treatment of patients with chronic renal failure (CRF) complicated with inguinal hernia and the impact on renal function.

Methods

A total of 80 patients with CRF and inguinal hernia who were admitted to the Department of Nephrology at Xinjiang Uygur Municipal People's Hospital from January 2022 to May 2023 were selected. They were randomly assigned to the control group (n=40) and the observation group (n=40),receiving open tension-free hernia repair and laparoscopic tension-free hernia repair, respectively. The two groups were compared on surgery-related indicators, recovery time of continuous ambulatory peritoneal dialysis, changes in renal function indicators before and after surgery, and the incidence of complications.

Results

Surgery time, ambulation time and postoperative hospital stay of the observation group[(46.61±4.05) min, (9.26±1.04) h and (3.05±1.02) d] were shorter than those of the control group[(54.28±5.92) min, (13.85±1.47) h and (4.77±1.65) d] (P＜0.05). The postoperative bleeding volume and VAS score on 2nd day after surgery [(5.31±0.75) ml and (2.35±1.06) ml] were smaller and lower than those of the control group [(6.34±0.92) ml and (3.62±1.17) ml] (P＜0.05). The observation group began planned resumption of peritoneal dialysis at 4 weeks after surgery, while the control group began at 6 weeks after surgery. The recovery time of peritoneal dialysis in the observation group [(31.28±4.05) days] was shorter than that in the control group [(49.06±5.17) days] (P＜0.05). After surgery, only serum creatinine (SCr),blood uric acid (UA) and β2-microglobulin (β2-MG) in the observation group [(440.05±51.09) μmol/L,(511.33±67.43) μmol/L and (4.10±0.40) mg/L] were significantly lower than those in the control group[(559.47±59.12) μmol/L, (592.69±43.58) μmol/L and (4.68±0.56) mg/L] (P＜0.05). At 1 month, 3 months and 5 months after surgery, the SF-36 scores of both groups increased (P＜0.05), and scores of the observation group [(64.11±7.04), (70.14±7.62) and (75.36±7.92)] were higher than those of the control group [(59.34±6.85), (65.28±6.84) and (70.21±7.16)] (P＜0.05). The total incidence of postoperative complications in the observation group (10.00%) was lower than that in the control group (27.50%)(P＜0.05).

Conclusion

Compared with open tension-free hernia repair, laparoscopic tension-free hernia repair has more advantages in treating patients with CRF and inguinal hernia, such as small wounds, fast recovery, significant effects and protection effects on renal function.

Key words: Inguinal hernia, Tension-free hernia repair, Chronic renal failure, Efficacy, Renal function

Xiaoqin Wang, Li Wang, Jianying Cui. Effect of tension-free hernia repair in the treatment of patients with chronic renal failure complicated with inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(05): 538-542.

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References 17

[1]	刘吉平, 张国胜, 高志伟. 腹腔镜经腹腔腹膜前腹股沟疝修补联合腹股沟小切口治疗特殊类型腹股沟疝[J]. 中国微创外科杂志,2022, 28(7): 599-602.
[2]	刘俏男, 崔常晋, 李波, 等. 腹膜透析合并腹股沟疝经腹腹膜前修补术1 例报告[J]. 腹腔镜外科杂志, 2022, 27(4): 313-314.
[3]	陈涛, 徐煜, 付学良, 等. 持续性非卧床腹膜透析病人并发腹股沟疝的外科治疗[J]. 外科理论与实践, 2021, 26(5): 425-429.
[4]	张建平. 无张力疝修补术治疗腹股沟疝的临床疗效及预后效果分析[J]. 中国药物与临床, 2021, 21(1): 99-101.
[5]	江鸣, 包文中, 姜友, 等. 膜解剖在腹腔镜腹股沟疝修补术中的特点及临床应用[J]. 中国临床解剖学杂志, 2021, 26(5): 39.
[6]	中国中西医结合学会肾脏疾病专业委员会. 慢性肾衰竭中西医结合诊疗指南[J]. 中国中西医结合杂志, 2015, 35(9): 1029-1033.
[7]	Glavor KD, Titlic M, Vuletić G, et al. Quality of life assessment in migraine and relapsing remitting multiple sclerosis: self-perceived health is similar[J]. Neurol Sci, 2019, 40(12): 2549-2554.
[8]	叶静, 黄永刚, 郭自成, 等. Lichtenstein 手术治疗腹膜透析患者腹股沟疝的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020,14(6): 598-600.
[9]	Sultan AAEA, Elazm HAA, Omran H. Lichtenstein versus transabdominal preperitoneal(TAPP) inguinal hernia repair for unilateral non recurrent hernia: a multicenter short term randomized comparative study of clinical outcomes[J]. Ann Med Surg(Lond),2022, 76(19): 103-105.
[10]	Jambor MA, Kyang LS, Romero M. Internal small bowel hernia via a peritoneal defect from laparoscopic totally extraperitoneal inguinal hernia repair[J]. ANZ J Surg, 2021, 92(3): 603-604.
[11]	仲罗平. 腹膜透析合并腹股沟疝的无张力修补术[D]. 南昌: 南昌大学医学部, 2019.
[12]	陈焕德, 林满洲, 陈明, 等. 慢性肾功能衰竭腹膜透析患者合并腹股沟疝的治疗体会[J]. 广东医科大学学报, 2023, 41(2): 203-205.
[13]	辜树勇, 彭启全. 腹腔镜下TEP 治疗CAPD 并发的腹股沟疝患者疗效分析[J]. 新医学, 2018, 49(7): 517-520.
[14]	Manuel V, Reddy VR, Rapur SV. Prevalence and outcome of abdominal wall hernia in patients with end-stage renal disease on peritoneal dialysis[J]. Ther Apher Dial, 2023, 27(2): 320-327.
[15]	沙洪存, 包蓓艳, 郝龙, 等. 腹膜透析的慢性肾功能衰竭患者合并腹股沟疝的无张力疝修补术[J]. 中华普通外科杂志, 2019,34(3): 261-262.
[16]	李茂婷, 赖学莉, 郭志勇. 腹膜透析合并疝的诊疗进展[J]. 中国中西医结合肾病杂志, 2021, 22(7): 647-649.
[17]	Changjin C, Lei Z, Li L, et al. Laparoscopic techniques in treatment of inguinal hernia in patients with peritoneal dialysis: experiences from 15 cases[J]. J Laparoendosc Adv Surg Tech A, 2023, 33(8):738-742.

组别	例数	手术时间(min)	下床活动时间(h)	术后住院时间(d)	术后出血量(ml)	术后第1天VAS评分(分)	术后第2天VAS评分(分)
试验组	40	46.61±4.05	9.26±1.04	3.05±1.02	5.31±0.75	1.65±0.38	2.35±1.06
对照组	40	54.28±5.92	13.85±1.47	4.77±1.65	6.34±0.92	1.71±0.40	3.62±1.17
t值		6.763	16.121	5.608	5.488	0.688	5.088
P值		＜0.001	＜0.001	＜0.001	＜0.001	0.494	＜0.001

组别	例数	手术时间(min)	下床活动时间(h)	术后住院时间(d)	术后出血量(ml)	术后第1天VAS评分(分)	术后第2天VAS评分(分)
试验组	40	46.61±4.05	9.26±1.04	3.05±1.02	5.31±0.75	1.65±0.38	2.35±1.06
对照组	40	54.28±5.92	13.85±1.47	4.77±1.65	6.34±0.92	1.71±0.40	3.62±1.17
t值		6.763	16.121	5.608	5.488	0.688	5.088
P值		＜0.001	＜0.001	＜0.001	＜0.001	0.494	＜0.001

组别	例数	血清肌酐(μmol/L)		血尿酸(μmol/L)		β2-微球蛋白(mg/L)
组别	例数	术前	术后	术前	术后	术前	术后
试验组	40	438.84±50.16	440.05±51.09	510.32±67.11	511.33±67.43	4.08±0.39	4.10±0.40
对照组	40	440.76±49.85	559.47±59.12^a	509.82±66.89	592.69±43.58^a	3.97±0.40	4.68±0.56^a
t值		0.172	9.666	0.033	6.409	1.245	5.330
P值		0.864	＜0.001	0.974	＜0.001	0.217	＜0.001

组别	例数	血清肌酐(μmol/L)		血尿酸(μmol/L)		β2-微球蛋白(mg/L)
组别	例数	术前	术后	术前	术后	术前	术后
试验组	40	438.84±50.16	440.05±51.09	510.32±67.11	511.33±67.43	4.08±0.39	4.10±0.40
对照组	40	440.76±49.85	559.47±59.12^a	509.82±66.89	592.69±43.58^a	3.97±0.40	4.68±0.56^a
t值		0.172	9.666	0.033	6.409	1.245	5.330
P值		0.864	＜0.001	0.974	＜0.001	0.217	＜0.001

组别	例数	术前	术后1个月	术后3个月	术后5个月
试验组	40	51.15±6.19	64.11±7.04^a	70.14±7.62^a	75.36±7.92^a
对照组	40	50.96±5.98	59.34±6.85	65.28±6.84	70.21±7.16
F _交互、P_交互			14.321、＜0.001
F _时间、P_时间			26.575、＜0.001
F _组间、P_组间			18.648、＜0.001

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