A controlled study of different hernia sac management in laparoscopic transabdominal preperitoneal procedure for indirect inguinal hernia

doi:10.3877/cma.j.issn.1674-392X.2021.03.022

Abstract

Abstract:

Objective

To compare the effects of different treatment methods of hernia sac on surgical complications of laparoscopic transabdominal preperitoneal (TAPP) repair in the treatment of indirect inguinal hernia.

Methods

A total of 80 patients with primary indirect inguinal hernia admitted to Jinshan Hospital of Fudan University from January 2017 to January 2019 were collected and divided into experimental group and control group, with 40 cases in each group. Intraoperative transection of the indirect hernia sac was performed in the experimental group, and complete restoration of the hernia sac was performed in the control group. The treatment time of hernia sac, operative time, incidence of postoperative hematoma, seroma, acute pain, chronic pain, length of hospital stay, recurrence rate and other complications were compared between the two groups.

Results

The treatment time of hernia sac in the experimental group was significantly shorter than that in the control group [(9.2±3.42) minutes vs (26.7±8.93) minutes, P<0.01]. The operative time of the two groups was (42.2±4.33) minutes and (59.0±8.44) minutes, respectively (P<0.01). There was no significant difference in length of postoperative hospital stay between the two groups. In terms of follow-up, there were no statistically significant differences in the incidence of hematoma, seroma, acute pain, chronic pain, and recurrence between the two groups.

Conclusion

Transection of hernia sac in laparoscopic transabdominal preperitoneal procedure for indirect inguinal hernia reduces the operation time and does not increase the incidence of complications such as seroma, acute or chronic pain.

Key words: Hernia,inguinal, Laparoscope, Hernia sac, Seroma, Pain, Recurrence

Wenhai Huang, Xiaoming Jiang. A controlled study of different hernia sac management in laparoscopic transabdominal preperitoneal procedure for indirect inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(03): 300-303.

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URL: https://zhshfbwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-392X.2021.03.022

https://zhshfbwkzz.cma-cmc.com.cn/EN/Y2021/V15/I03/300

Figures/Tables 3

References 14

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变量		试验组(40例)	对照组(40例)	P值
性别				0.164
	男性	37(92.50)	38(95.00)
	女性	3(7.50)	2(5.00)
年龄		59.32±8.77	60.14±8.43	0.272
BMI(kg/m²)		18.9±3.1	19.1±3.0	0.209
疝位置				0.339
	左侧	12(30.00)	13(32.50)
	右侧	21(52.50)	22(55.00)
	双侧	7(17.50)	5(12.50)
疝缺损大小(cm)				0.129
	>3	12(30.00)	14(35.00)
	<3	28(70.00)	26(65.00)
ASA分级				0.063
	Ⅰ级	24(60.00)	22(55.00)
	Ⅱ级	16(40.00)	18(45.00)
随访时间(个月)		12.2±0.5	12.4±0.2	0.345

变量		试验组(40例)	对照组(40例)	P值
性别				0.164
	男性	37(92.50)	38(95.00)
	女性	3(7.50)	2(5.00)
年龄		59.32±8.77	60.14±8.43	0.272
BMI(kg/m²)		18.9±3.1	19.1±3.0	0.209
疝位置				0.339
	左侧	12(30.00)	13(32.50)
	右侧	21(52.50)	22(55.00)
	双侧	7(17.50)	5(12.50)
疝缺损大小(cm)				0.129
	>3	12(30.00)	14(35.00)
	<3	28(70.00)	26(65.00)
ASA分级				0.063
	Ⅰ级	24(60.00)	22(55.00)
	Ⅱ级	16(40.00)	18(45.00)
随访时间(个月)		12.2±0.5	12.4±0.2	0.345

变量		试验组(40例)	对照组(40例)	P值
疝囊处理时间(min, ±s)		9.2±3.42	26.7±8.93	0.001
手术时间(min, ±s)		42.2±4.33	59.0±8.44	0.001
住院时间(d, ±s)		2.5±1.15	2.8±1.29	0.156
急性疼痛[例(%)]		2(2.22)	3(3.33)	0.121
血肿[例(%)]		1(1.11)	1(1.11)	0.899
血清肿[例(%)]
	1周	6(15.00)	7(17.50)	0.066
	1个月	3(7.50)	4(10.00)	0.104
	3个月	1(2.50)	2(5.00)	0.070
慢性疼痛[例(%)]		1(1.11)	2(2.22)	0.299
复发[例(%)]		0	0	-

变量		试验组(40例)	对照组(40例)	P值
疝囊处理时间(min, ±s)		9.2±3.42	26.7±8.93	0.001
手术时间(min, ±s)		42.2±4.33	59.0±8.44	0.001
住院时间(d, ±s)		2.5±1.15	2.8±1.29	0.156
急性疼痛[例(%)]		2(2.22)	3(3.33)	0.121
血肿[例(%)]		1(1.11)	1(1.11)	0.899
血清肿[例(%)]
	1周	6(15.00)	7(17.50)	0.066
	1个月	3(7.50)	4(10.00)	0.104
	3个月	1(2.50)	2(5.00)	0.070
慢性疼痛[例(%)]		1(1.11)	2(2.22)	0.299
复发[例(%)]		0	0	-

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