To compare the effect of laparoscopic trans-abdominal preperitoneal repair (TAPP) and traditional tension-free repair in the treatment of inguinal hernia, with emphasis on the effects on postoperative pain, seroma and recurrence.

This was a retrospective cohort study. A total of 81 patients with inguinal hernia admitted to the Second People's Hospital of Bengbu between January 2019 and June 2022 were included. The patients were divided into a laparoscopic group (TAPP, n=43) and an open group (traditional tension-free repair, n=38) according to the different surgical methods. The surgical-related indicators, pain degree, changes in inflammatory factor levels before and after surgery, and the incidence of complications 1-year after surgery were compared between the two groups of patients.

The surgeries were successful in both groups. The surgical time in laparoscopic group was longer than that in open group [(61.59±10.42) min vs (40.31±9.65) min, P<0.05], and the postoperative blood loss was less than that in open group [(12.18±2.59) ml vs (29.04±4.75) ml, P<0.05], and the postoperative ambulation time, postoperative exhaust time and postoperative hospital stay were all shorter than those in open group [(6.75±1.18) h, (16.82±3.75) h, (4.16±0.98) d vs (9.16±1.52) h, (22.04±4.17) h, (4.69±1.21) d, all P<0.05]. The visual analogue scale (VAS) pain scores in laparoscopic group at 6 h, 1 d, 3 d, and 7 d after surgery were (4.53±0.61) points, (3.19±0.35) points, (2.46±0.31) points and (1.81±0.29) points, which were lower than those in open group [(5.27±0.68) points, (3.52±0.39) points, (2.73±0.30) points, (2.14±0.34) points, all P<0.001]. The levels of CRP, IL-6 and MMP-9 in laparoscopic group were lower than those in open group (all P<0.001). In laparoscopic group, there were 3 cases of Morales type Ⅰ and 1 case of type Ⅱ seroma. In open group, there were 7 cases of type Ⅰ, 2 cases of type Ⅱ, 1 case of type Ⅲ and 1 case of type Ⅳ seroma. The degree of seroma in laparoscopic group was milder than that in open group (Z=5.269, P=0.022). Recurrence occurred in 1 case (2.33%) in laparoscopic group and 2 cases (5.26%) in open group within 1 year after surgery. There was no significant difference in recurrence rate between the two groups (χ²=0.488, P>0.05). The total incidence of other complications in the laparoscopic group was lower than that in the open group (4.65% vs 21.05%; χ²=5.015, P=0.025).

Compared with open tension-free repair, TAPP can better relieve the postoperative pain and reduce the incidence of seroma, but the recurrence rates of the two types of surgery are comparable.