The clinical comparative study of tension-free repair under local anesthesia and transabdominal preperitoneal for hernioplasty / 中国医师进修杂志

ABSTRACT

Objective To compare the clinical efficiency of tension-free repair(Lichtenstein) under local anesthesia and transabdominal preperitoneal (TAPP) for hernioplasty.Methods The clinical data of 120 patients with Lichtenstein for hernioplasty under local anesthesia (Lichtenstein group) and 98 patients with TAPP for hemioplasty (TAPP group) from January 2010 to July 2012 were analyzed.Results The operation time,blood loss and number of concurrent hernia found in the operation in Lichtenstein group was significantly lower than that in TAPP group [(40.1 ± 4.5) min vs.(45.7 ± 3.5) min,P ＜ 0.01 ; (6.7 ± 1.3) ml vs.(10.6 ± 2.3) ml,P ＜ 0.01 ; 10.2％ (10/98) vs.1.7％ (2/120),P =0.006].In Lichtenstein group,the frequency of analgesic drug used in 3 d after operation,time of return to regular activity were significant higher than those in TAPP group [(0.31 ± 0.03) times vs.(0.22 ± 0.09) times,(9.32 ± 1.38) d vs.(6.54 ±0.98) d],but the time to ambulation,hospital stay,and cost were lower[(5.34 ± 1.98) h vs.(10.24 ± 2.35)h,(2.98 ± 1.32) d vs.(6.43 ±0.93) d,(5032.15 ±372.18) yuan vs.(8325.76 ±438.23) yuan](P=0.010).The rate of complications had no significant difference between two groups (P =0.067).The rate of chronic pain in Lichtenstein group was significantly higher than that in TAPP group [10.0％(12/120) vs.0,P =0.001].The rate of real recurrent hernias in Lichtenstein group had no significant difference compared with TAPP group (P =0.199),but the rate of false recurrent hernias in Lichtenstein group was significantly higher than that in TAPP group [6.7％(8/120) vs.0,P =0.009].Conclusion Both of Lichtenstein under local anesthesia and TAPP for hemioplasty are safety and effective,and each has its advantages.