Effect of laparoscopic complete peritoneal hernia repair on respiratory function and motilin in elderly patients with inguinal hernia / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effects of laparoscopic total extraperitoneal hernia repair (TEP) on respiratory function and motilin (MOL) in elderly patients with inguinal hernia.Methods:One hundred and twenty elderly patients with inguinal hernia admitted in Chongqing Fengdu People′s Hospital from January 2020 to December 2021 were divided into two groups according to the method of operation, 60 patients who performed laparoscopic preperitoneal hernia repair (TAPP) was enrolled in control group, and 60 patients who performed TEP was enrolled in the study group. The operation index, visual analogue scale (VAS) scores at different time, respiratory function index and gastrin (GAS), MOL levels and postoperative complications were compared between the two groups.Results:Compared with the control group, the operation time in the study group was longer, the recovery time was shorter and the VAS scores were lower on the 1st, 3rd and 7th day after operation: (66.36 ± 10.05) min vs. (53.69 ± 8.59) min, (4.09 ± 0.59) d vs. (5.15 ± 1.06) d, (4.49 ± 1.26) scores vs. (5.46 ± 1.48) scores, (3.65 ± 0.58) scores vs. (4.52 ± 0.95) scores, (2.42 ± 0.41) scores vs. (3.54 ± 0.48) scores, there were statistical differences ( P<0.05). The levels of end-expiratory carbon dioxide pressure (P ETCO 2) and airway pressure (Paw) in the study group at 10, 30 and 90 min postoperatively were higher than those in the control group: (40.66 ± 4.52)mmHg(1 mmHg = 0.133 kPa) vs. (37.48 ± 5.26) mmHg, (19.88 ± 1.63) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (16.59 ± 2.15) cmH 2O; (44.65 ± 4.18) mmHg vs. (41.58 ± 4.58) mmHg, (20.49 ± 1.65) cmH 2O vs. (16.95 ± 2.84) cmH 2O; (50.16 ± 3.54) mmHg vs. (45.59 ± 4.65)mmHg, (21.69 ± 1.78) cmH 2O vs. (17.49 ± 2.15) cmH 2O, there were statistical differences ( P<0.05). The levels of MOL and GAS in the study group at 3 d postoperatively were higher than those in the control group: (396.54 ± 13.58) ng/L vs. (332.52 ± 16.95) ng/L, (118.95 ± 8.95) ng/L vs. (102.58 ± 10.65) ng/L, there were statistical differences ( P<0.05). There was no significant difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Both TEP and TAPP have certain therapeutic effects on the inguinal hernia, but TEP has shorter postoperative recovery time, less pain, less impact on gastrointestinal function, but it will have a certain impact on respiratory function.