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Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) ›› 2020, Vol. 14 ›› Issue (02): 164-167. doi: 10.3877/cma.j.issn.1674-392X.2020.02.017

Special Issue:

• Clinical Article • Previous Articles     Next Articles

Effect of laparoscopic total extraperitoneal and transabdominal preperitoneal hernia repair on patients with recurrent hernia after mesh plug repair

Shi Xu1,(), Xiaofeng Yu1   

  1. 1. Department of General Surgery, Suzhou High-tech Zone People's Hospital of Jiangsu Province, Suzhou 215129, China
  • Received:2019-09-29 Online:2020-04-18 Published:2020-04-18
  • Contact: Shi Xu
  • About author:
    Corresponding author: Xu Shi, Email:

Abstract:

Objective

To explore the effect of using laparoscopic total extraperitoneal (TEP) and transabdominal peritoneal (TAPP) hernia repair on in patients with recurrent hernia after mesh plug repair.

Methods

Between March 2012 and April 2018, 169 patients with recurrent hernia who had relapsed after the repair of mesh plug in Suzhou Hi-tech Zone People's Hospital were selected as subjects. The laparoscopic hernia repair (total extraperitoneal or transabdominal preperitoneal hernia repair) was performed, and patient data were collected retrospectively. According to the random number table, they were divided into the TAPP group (n=98) and the TEP group (n=71). The postoperative acute and chronic pain visual analogue scale (VAS), complications and recurrence were compared between the two groups. The operation time, intraoperative bleeding volume, VAS, etc., were measured as (±s), independent samples were used t test for comparison between groups. The recurrence, adverse reactions, etc., as the count data, expressed as the rate, compared with the χ2 test.

Results

There was no significant difference in operation time between the two groups, but the amount of bleeding and postoperative hospital stay in the TEP group were significantly lower than those in the TAPP group (P<0.05). 1 day, 7 days, 15 days and 30 days after operation, the scores of VAS in the TEP group were lower than those in the TAPP group and the difference was statistically significant (P<0.05). The recurrence rate in the TEP group was 0.70%, which was significantly lower than that in the TAPP group (4.59%, P<0.05). There were no significant differences in seroma, urinary retention, incision and scrotum edema, and wound infection between the two groups (P>0.05). The abnormal nerve sense in the TAPP group was significantly higher than that in the TEP group (P<0.05).

Conclusion

Compared with laparoscopic TAPP repair, the laparoscopic TEP repair for recurrent hernia after mesh plug repair has the advantages of small intraoperative bleeding and fast postoperative recovery, which can effectively relieve postoperative acute and chronic pain, and the incidence and recurrence rate of neurosensory abnormalities are low.

Key words: Recurrent hernia, Complications, Acute and chronic pain, Herniorrhaphy

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