A comparative study on the effects of transabdominal preperitoneal hernia repair and open hernia repair surgery in the treatment of adult inguinal hernia / 中国综合临床

ABSTRACT

Objective To evaluate the clinical outcomes of different stages of transabdominal preperitoneal hernia repair (TAPP) and open hernia repair surgery (Rutkow) in treating adult inguinal hernia.Methods The clinical data of patients with inguinal hernia undergoing hernia repair(TAPP,TAPP Ⅰ group56 patients administered TAPP during January 2003 to December 2005 ; TAPP Ⅱ group76 patients administered TAPP during January to December 2010) and Rutkow hernia-ring filling (Rutkow group78 patients administered Rutkow during January 2003 and December 2005) were analyzed retrospectively.Clinical indexes and effective indicators were observed to compare the treatment effects of the operation procedures,including duration of surgery,post-operation hospital stay,post-operation leaving bed time,post-operation free activity time,hospitalization costs,time of beginning taking food,and complications.Results The TAPP Ⅱ group had significantly shorter average length of stay,time of beginning taking food,post-operation leaving bed time and post-operation free activity time than the other two groups (average length of stay(2.6 ± 1.6) d vs.(4.1 ±2.6) d vs.(4.2 ± 1.9) d; time of beginning taking food(8.6 ± 3.1) h vs.(22.2 ± 3.8) h vs.(20.7 ± 3.2)h;post-operation leaving bed time(4.6 ±2.2) h vs.(18.3 ±2.3) h vs (20.5 ±3.1) h;Post-operation free activity time(8.6 ± 2.9) d vs.(15.2 ± 3.3) d vs.(17.1 ± 3.8) d ; P ＜ 0.05).There were no significant differences between TAPP Ⅰ and Rutkow groups on average length of stay,time of beginning taking food,postoperation leaving bed time and post-operation free activity time (P ＞ 0.05).TAPP Ⅰ group had significantly longer duration of operation than the other two groups ((113.3 ± 18.6) min vs.(50.4 ± 11.8) min vs.(48.6 ± 12.1) min,P ＜ 0.05).There was no difference on surgery duration between Rutkow and TAPP Ⅱ groups (P ＞ 0.05).No difference was observed regarding rates of postoperative complications and recurrence (P ＞ 0.05).Conclusion With the advancement of technology,TAPP shows more advantages compared to traditional herniorrhaphy,such as minimal trauma,fewer complications and shorter duration of operation and lower recurrence rate.TAPP is an excellent hernia repair for inguinal hernia.