Comparison of laparoscopic total extraperitoneal hernia repair and mesh-plug tension-free hernia repair in elderly patients with inguinal hernia

doi:10.3877/cma.j.issn.1674-392X.2023.02.013

Abstract

Abstract:

Objective

To investigate the effects of laparoscopic total extraperitoneal hernia repair (TEP) and mesh-plug tension-free hernia repair in the treatment of elderly patients with inguinal hernia.

Methods

A total of 111 elderly patients with inguinal hernia who were admitted to Xuancheng People 's Hospital from April 2020 to May 2022 were selected and divided into the control group (55 cases) and the observation group (56 cases) according to the random number table method. The control group was treated with mesh-plug filling for tension-free hernia repair, and the observation group was treated with TEP. The perioperative indicators, preoperative and 7 d serological indicators, quality of life, and complications within 3 months after surgery were compared between the two groups.

Results

Compared with the control group, the observation group had less bleeding during the operation and a shorter time to restore normal activity, as well as a shorter duration of postoperative pain and hospital stay. Compared with pre-surgery, 7 d after surgery serum hs-CRP、CRP and PCT levels in the two groups increased, which were lower in the observation group than in the control group. The WBC count, neutrophil percentage, erythrocyte aggregation index increased in both groups, but the detection values in the observation group were lower than those in the control group. Various scores of quality of life all increased in both groups, and the scores in the observation group were higher than those in the control group. The total incidence of complication in that observation group is lower than that in the control group within three months after operation. All the differences were statistically significant (P<0.05). In 3 months of follow-up, there was no significant difference in the recurrence rate between the two groups (P>0.05).

Conclusion

Laparoscopic total extraperitoneal hernia repair for inguinal hernia in elderly patients has the advantages of a milder inflammatory reaction in the body, shorter postoperative recovery time, reduced incidence of postoperative complications in patients, and improved quality of life, with little effect on hemorheological index of patients.

Key words: Hernia, inguinal, Elderly, Laparoscope, Herniorrhaphy

Chengdong Liu, Yijun Gong, Zemin Xie, Wei Cui. Comparison of laparoscopic total extraperitoneal hernia repair and mesh-plug tension-free hernia repair in elderly patients with inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(02): 181-185.

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References 24

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组别	例数	性别		年龄(岁,±s)	体质量指数(kg/m²,±s)	美国麻醉医师协会分级		疝分类
组别	例数	男性	女性	年龄(岁,±s)	体质量指数(kg/m²,±s)	Ⅰ级	Ⅱ级	斜疝	直疝	股疝
对照组	55	51(92.73)	4(7.27)	72.55±3.23	23.15±1.02	11(20.00)	44(80.00)	46(83.64)	6(10.91)	3(5.45)
观察组	56	51(91.07)	5(8.93)	72.47±3.17	23.11±1.01	12(21.43)	44(78.57)	48(85.71)	6(10.71)	2(3.57)
t/χ²值		0.102		0.132	0.208	0.034		0.092
P值		0.749		0.895	0.836	0.853		0.761

组别	例数	性别		年龄(岁,±s)	体质量指数(kg/m²,±s)	美国麻醉医师协会分级		疝分类
组别	例数	男性	女性	年龄(岁,±s)	体质量指数(kg/m²,±s)	Ⅰ级	Ⅱ级	斜疝	直疝	股疝
对照组	55	51(92.73)	4(7.27)	72.55±3.23	23.15±1.02	11(20.00)	44(80.00)	46(83.64)	6(10.91)	3(5.45)
观察组	56	51(91.07)	5(8.93)	72.47±3.17	23.11±1.01	12(21.43)	44(78.57)	48(85.71)	6(10.71)	2(3.57)
t/χ²值		0.102		0.132	0.208	0.034		0.092
P值		0.749		0.895	0.836	0.853		0.761

组别	例数	术中出血量(ml)	术后疼痛持续时间(d)	恢复正常活动时间(h)	住院时间(d)
对照组	55	32.56±4.70	3.16±0.45	10.23±1.58	8.48±1.52
观察组	56	26.62±1.53	0.92±0.23	8.72±1.14	3.76±0.46
t值		8.986	33.108	5.782	22.226
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	术中出血量(ml)	术后疼痛持续时间(d)	恢复正常活动时间(h)	住院时间(d)
对照组	55	32.56±4.70	3.16±0.45	10.23±1.58	8.48±1.52
观察组	56	26.62±1.53	0.92±0.23	8.72±1.14	3.76±0.46
t值		8.986	33.108	5.782	22.226
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	PCT(ng/ml)		hs-CRP(mg/L)		CRP(mg/L)
组别	例数	术前	术后7 d	术前	术后7 d	术前	术后7 d
对照组	55	0.13±0.05	0.93±0.09*	0.35±0.03	3.26±0.26*	3.84±0.52	12.21±0.65*
观察组	56	0.12±0.05	0.55±0.08*	0.36±0.03	1.25±0.15*	3.96±0.51	10.12±0.49*
t值		1.054	23.521	1.756	49.999	1.227	19.151
P值		0.294	<0.001	0.082	<0.001	0.222	<0.001

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