Abstract:
Objective To investigate the clinical effect of laparoscopic intraperitoneal implantation (IPOM) and preperitoneal space implantation [laparoscopic transabdominal hernia repair (TAPP) and totally extraperitoneal repair (TEP)] in the treatment of inguinal hernia. The treatment costs and health resource utilization were compared between TAPP and TEP.
Methods A retrospective study was conducted on 153 patients with laparoscopic inguinal hernia repair (LIHR) who were treated in Central Hospital of Xuzhou City from June 2014 to December 2015. There were 102 patients undergoing intraperitoneal patch implantation, 30 cases of TAPP, and 21 cases of TEP. The basic information and postoperative clinical symptoms were compared between laparoscopic intraperitoneal patch implantation and preperitoneal space patch implantation.
Results There were 18 cases and 1 case of chronic pain in laparoscopic intraperitoneal implantation group and preperitoneal space patch implantation group, respectively. And the difference was statistically significant (P<0.05). 8 patients with seroma in laparoscopic intraperitoneal patch implantation group were significantly more than 2 patients in preperitoneal space patch implantation group (P<0.05). There were no significant differences in sensory disturbance, postoperative infection, hospitalization time and recurrence rate between the two groups (P>0.05). The levels of serum MMP-2 and MMP-9 in the two groups were significantly lower than those before treatment (P<0.05). There were no significant differences in examination costs, operation costs, drug costs, nursing costs, indirect costs and total costs between TAPP and TEP (P>0.05). TAPP and TEP had same therapeutic effect in the treatment of inguinal hernia. TEP improved resource utilization by reducing the cost of materials.
Conclusion Laparoscopic intraperitoneal patch implantation and preperitoneal space patch implantation are effective surgical methods for the treatment of inguinal hernia. The preperitoneal space patch implantation is superior to laparoscopic intraperitoneal patch implantation on clinical outcomes.
Key words:
Hernia, inguinal,
Herniorrhaphy,
Laparoscopes
Jin Li, Minkang Zhang, Hao Guo, Qianjin Zhang, Qinliang Meng, Qinzhong Tian. Clinical study of different patch implantation in the treatment of inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2018, 12(02): 120-123.