Clinical randomized controlled trial of laparoscopic totally extraperitoneal herniorrhaphy and totally extraperitoneal herniorrhaphy via hypogastric midline incision in treatment of bilateral inguinal hernias / 国际外科学杂志

ABSTRACT

Objective To explore the clinical value of laparoscopic totally extraperitoneal herniorrhaphy (LTEP) and open to tally extraperitoneal (OTEP) for bilateral inguinal hernias.Methods From January 2015 to December 2017,61 male patients with bilateral inguinal hernias,who were in accordance with the inclusion criteria,were prospectively randomized into laparoscopic totally extraperitoneal herniorrhaphy group (LTEP group,n =31)or totally extraperitoneal herniorrhaphy via hypogastric midline incision group(OTEP group,n =30).Operative outcomes,postoperative complications,recurrence,the levels of C-reactive protein (CRP) were analyzed.The data were analyzed by statistical software.Results The operative baselines of patients in two groups were equivalent.In patients who received laparoscopic totally extraperitoneal herniorrhaphy,decreased levels of CRP on the 1th day after operation,postoperative ambulation and hospital stay [(88.7 ± 18.5) mg/L vs (102.0 ±25.1) mg/L,P=0.022];[(5.6±2.2) h vs (20.0±5.5) h,P＜0.001;(3.0±0.6) dvs (4.5±1.0) d,P ＜ 0.001],were found compared with the OTEP group significantly,LTEP group had more hospitalization expense than OTEP group [(14 779.3 ± 1450.1) yuan vs (13 650.0 ± 1 787.3) yuan,P ＜ 0.001].There were no mesh infection,chronic pain,scrotal edema and recurrence of inguinal hernia in two groups.No difference was found between the two groups in the other operative outcomes and postoperative complications.Conclusion Both laparoscopic totally extraperitoneal herniorrhaphy and totally extraperitoneal herniorrhaphy via hypogastric midline incision are effective and safe in the treatment of bilateral inguinal hernias,each has both advantages and disadvantages,and complement each other.