Comparative Analysis of the Efficacy of Transabdominal Pre-Peritoneal Vs Open Tension-Free Hernia Repair in Treating Inguinal Hernia

Objective:To investigate and analyze the clinical outcomes of inguinal hernia patients treated with transabdominal pre-peritoneal repair(TAPP)versus open tension-free hernia repair.Methods:The study was carried out from January 2021 to August 2023,and a total of 50 inguinal hernia patients were selected for this study.The patients were randomly divided into a study group(n=25)and a control group(n=25)by the numerical table method.The patients in the control group were treated with open tension-free hernia repair,whereas the patients in the study group were treated with TAPP.The surgical and postoperative recovery indexes,complication rates,and recurrence rates of the two groups were compared.Results:There was no significant difference in the operative time and intraoperative blood loss between the two groups(P>0.05),and the postoperative feeding time,time out of bed,and hospitalization time of the study group were shorter than those of the control group(P<0.05);the incidence rate of postoperative complications in the study group was lower than that in the control group(P<0.05);and there was no significant difference in the recurrence rate of the two groups after operation(P>0.05).Conclusion:Compared to open tension-free hernia repair,TAPP offers a shorter postoperative recovery duration and hospitalization time,and reduces the incidence of complications.Therefore,this surgical method should be popularized in the treatment of inguinal hernia.

Analysis of the Effect and Efficiency of Tension- Free Hernia Repair and Traditional Surgery in The Treatment of Hernia

Objective: To analyze the efficiency of tension-free hernia repair and traditional surgery in the treatment of hernia. Methods: A total of 80 patients with hernias were selected and randomly into a control group (traditional hernia repair) and an observation group (tension-free hernia repair), of 40 cases each. The perioperative indicators, pain, physiological stress indicators, complications, and recurrence rates between the two groups were compared. Results: The perioperative indexes of the observation group were better than those of the control group (P < 0.05). The postoperative pain score, postoperative physiological stress index level, incidence of complications, and recurrence rate of the observation group were lower than those of the control group (P < 0.05). Conclusion: In the surgical treatment of hernia, tension-free hernia repair was less traumatic and had a better effect than traditional hernia repair.

Analysis of Ultrasound-guided Ilioinguinal and Iliohypogastric Nerve Block in Tension-Free Inguinal Hernia Repair in Elderly Patients

Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method,with 35 cases each.The control group underwent infiltration of local anesthesia(LA),and the study group added with IINB.The visual analogue scale(VAS)scores of the two groups of patients were compared.Results:The VAS score of the study group when pulling the hernia sac was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:IINB has good analgesic effect in tensionfree inguinal hernia repair in elderly patients,and it is worth promoting.

Current trends in laparoscopic groin hernia repair: A review

Hernia is a common problem of the modern world with its incidence more in developing countries. Inguinal hernia is the most common groin hernia repaired worldwide. With advancement in technology operative techniques of repair have also evolved. A Pub Med and COCHRANE database search was accomplished in this regard to establish the current status of laparoscopic inguinal hernia repair in view of recent published literature. Published literature support that laparoscopic hernia repair is best suited for recurrent and bilateral inguinal hernia although it may be offered for primary inguinal hernia if expertise is available.

Analysis of the Causes of Chronic Pain after Inguinal Hernia Repair without Tension and Its Prevention and Treatment

Purpose: Analyzing the causes of pain after tension-free repair in the inguinal hernia, and propose corresponding treatment strategies. Results: The patients in this group were followed up for 3 - 12 months. A total of 5 patients still had pain relief within 3 months after surgery. Further treatment was needed, and the incidence rate was 5%. Conclusion: Skilled surgical procedures are performed in patients with local anesthesia, and some of the absorbable repair materials can be used. The improved patch fixation and extra peritoneal repair can reduce the pain after inguinal hernia repair without tension.

Laparoscopic bilateral inguinal hernia repair: Should it be the preferred technique?

Inguinal hernias are amongst the most common conditions requiring general surgical intervention.For decades,the preferred approach was the open repair.As laparoscopy became more popular and available and more surgeons became familiarized with this modality,laparoscopic inguinal hernia repair became an alternative.The aim of this study is to assess the effectiveness of laparoscopic inguinal repair,with a focus on bilateral inguinal hernias.Initial reports have shown promising clinical outcomes compared to those of conventional repair of bilateral hernias.However,there are only a few studies concerning laparoscopic repair of bilateral hernias.It is yet to be proven that laparoscopy is the“gold standard”in the treatment of bilateral inguinal hernias.So far,the choice of an inguinal hernia repair technique has been up to each surgeon,depending on their expertise and available resources after taking into consideration each patient’s needs.

Ultra-Pro Hernia System for Repair of Primary Complex Inguinal Hernia: Should It Be the Technique of Choice?

Purpose: The introduction of light weight three-dimension meshes into the field of inguinal hernia repair showed excellent outcomes. Ultrapro Hernia System (UHS) is one of these three-dimension meshes that allow reinforcing the pre-peritoneal space with minimal fixation. It improves the patient quality of life with rapid resumption of the daily activities. The aim of this study is to evaluate the short-term outcomes of open mesh repair of primary complex inguinal hernia using UHS mesh. Methods: Between November 2013 and November 2015, seventy five male patients with complex primary inguinal hernia were submitted to open inguinal hernia mesh repair using the UHS. Results: The mean age was 46.1 years. Thirty three patients had inguinoscrotal hernias, 14 with Nyhus type IIIA, 22 with Nyhus type IIIB, & 6 patients had strangulated hernias. The mean operative time was 48 minutes. No operative complications were recorded. Post-operatively, the mean VAS scale on 1 day, 1 week, & 1 month was 3.22, 1.2, & 0.3 respectively. The mean duration of oral analgesics use was 2.1 days. None of the patients reported any chronic pain at 12 months post-operatively. Two cases of superficial wound infection were recorded that were treated by oral antibiotics. No recurrence was reported during a mean follow-up period of 26 months. Conclusion: Inguinal hernia repair using UHS is an effective technique that combines the advantages of the anterior and the pre-peritoneal approaches. It improves the patient’s quality of life with minimal recurrence rates. A larger number of patients with longer follow up periods are needed to increase the validity of our results.

镜疝修补术与开放式无张力疝修补术治疗腹股沟疝疗效对比研究

目的对比研究镜疝修补术治疗腹股沟疝的临床疗效。方法方便选取2019年6月—2023年10月启东市第二人民医院收治的123例腹股沟疝患者,采用密闭信封法分为对照组(n=61)、研究组(n=62)。对照组行开放式无张力疝修补术,研究组行镜疝修补术。比较两组围术期指标及并发症发生率。结果研究组手术时间长于对照组,其他指标优于对照组,差异有统计学意义(P均<0.05)。研究组并发症发生率(3.23%)低于对照组(14.75%),差异有统计学意义(χ^(2)=4.768,P<0.05)。结论镜疝修补术治疗腹股沟疝的效果优于传统术式,该手术方式具有微创性,对患者机体损伤较轻,同时,该种术式能够降低并发症风险,具有较高的安全性,有利于患者术后机体康复,从而改善患者预后。

腹腔镜疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的有效性及安全性比较

目的探讨腹腔镜疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的有效性与安全性。方法随机选择2020年1月—2023年1月莆田学院附属医院胃肠外科收治的350例成人腹股沟疝患者,以随机数表法将其分为观察组(175例)和对照组(175例),对照组患者应用开放式无张力疝修补术治疗,观察组患者应用腹腔镜疝修补术治疗,比较两组患者的临床疗效,手术时间、下床活动时间、痛感持续时间、术中出血量、住院时间等手术及恢复指标,患者术后1~3 d视觉模拟评分(Visual Analogue Scale,VAS),发生切口感染、尿潴留等并发症发生率以及随访6个月的复发率。结果观察组治疗总有效率为97.71%,高于对照组的81.14%,差异有统计学意义(χ^(2)=25.417,P<0.05)。观察组手术时间比对照组长,术中出血量、下床活动时间、痛感持续时间和住院时间等手术、恢复指标均短于对照组,差异有统计学意义(P均<0.05)。术后1~3 d观察组患者VAS评分低于对照组,差异有统计学意义(P<0.05)。并发症发生率为8.57%,低于对照组的20.57%,差异有统计学意义(P<0.05)。两组随访6个月均未存在复发病例。结论针对成人腹股沟疝患者应用腹腔镜疝修补术治疗比开放式无张力疝修补术治疗更有效,安全性更高,患者术后疼痛少,恢复时间短。

不同疝修补术治疗成年男性腹股沟疝临床比较

目的:比较腹腔镜经腹腹膜前疝修补术(TAPP)、完全腹膜外疝修补术(TEP)及开放疝修补术治疗成年男性腹股沟疝的效果。方法:采用回顾性分析,收集2017年12月—2020年12月于单县东大医院行腹股沟疝切除术患者作为研究对象,采用倾向性评分匹配(PSM)均衡组间协变量,共纳入121例患者,根据手术方式分为A组(36例行TAPP),B组(39例行TEP),C组(46例行开放手术疝修补术)。比较三组相关指标,所有患者均随访至2021年12月,比较三组复发情况。结果:A组、B组术中出血量少于C组,A组、B组术后疼痛持续时间、术后下床时间、住院时间均短于C组,C组手术时间短于A组、B组,A组手术时间短于B组,差异有统计学意义(P<0.05)。三组术后3 d、5 d胃泌素(GAS)水平、睾丸动脉最大血流速度比较,C组低于A组和B组,差异有统计学意义(P<0.05);A组、C组手术前后GAS比较,差异有统计学意义(P<0.05);C组手术前后睾丸动脉最大血流速度比较,差异有统计学意义(P<0.05)。A组、B组并发症发生率低于C组,差异有统计学意义(P<0.05);三组复发率比较,差异无统计学意义(P>0.05)。结论:TEP和TAPP与开放疝修补术比较创伤小,对局部血流影响小,并发症少;TEP与TAPP和开放疝修补术比较对消化系统影响更小,但TEP手术时间长,对术者要求高。

开放腹膜前修补术治疗成人小型脐疝的临床效果观察

目的观察开放腹膜前修补术治疗成人小型脐疝的临床效果。方法回顾性分析2018年1月至2022年10月济宁医学院附属金乡医院收治的88例小型脐疝患者的临床资料,根据手术方式将其分为观察组(采用开放腹膜前修补术,n=42)和对照组(采用传统缝合修补术,n=46)。比较两组手术时间、术中出血量、术后视觉模拟量表(VAS)评分、切口愈合等级、住院时间,以及术后血清肿、局部感觉异常、慢性疼痛和复发情况。结果88例患者均顺利完成手术。观察组手术时间显著长于对照组[(51.24±12.64)minvs(42.04±11.88)min;t=3.419,P=0.001]。两组术后VAS评分均呈下降趋势(P<0.05)。在术后第1天和第2天,观察组VAS评分显著低于对照组(P<0.05),两组VAS评分在术后第3天比较差异无统计学意义(P>0.05)。两组术中出血量、切口愈合等级,以及术后血清肿、慢性疼痛、局部感觉异常发生率比较差异无统计学意义(P>0.05)。观察组和对照组中位随访时间分别为19个月和17个月,随访期间观察组无复发,对照组有5例复发,两组复发情况比较差异有统计学意义(log-rank检验:χ_(2)=4.833,P=0.027)。结论开放腹膜前修补术治疗成人小型脐疝安全有效,值得临床推荐。

腹腔镜经腹腹膜前疝修补术与开放式无张力疝修补术治疗腹股沟斜疝患者的效果比较

目的:比较腹腔镜经腹腹膜前疝修补术(TAPP)与开放式无张力疝修补术治疗腹股沟斜疝患者的效果。方法:选取2020年9月至2023年9月该院收治的90例腹股沟斜疝患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各45例。对照组采用开放式无张力疝修补术治疗,研究组采用TAPP治疗,比较两组围术期指标水平,手术前后基质金属蛋白酶-2(MMP-2)水平、生命质量[生活质量综合评定问卷-74(GQOLI-74)]评分,术后疼痛程度[视觉模拟评分法(VAS)]评分,以及并发症发生率。结果:研究组首次下床活动时间、手术时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3 d,研究组心理功能、物质生活状态、躯体功能和社会功能等GQOLI-74评分均高于对照组,差异有统计学意义(P<0.05);术后7 d,研究组MMP-2水平低于对照组,差异有统计学意义(P<0.05);术后1、3 d,研究组VAS评分均低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为6.67%(3/45),低于对照组的22.22%(10/45),差异有统计学意义(P<0.05)。结论:TAPP治疗腹股沟斜疝患者可提高生命质量评分,改善围术期指标水平,降低MMP-2水平、VAS评分和并发症发生率,效果优于开放式无张力疝修补术治疗。

腹腔镜疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的对比研究

目的探讨成人腹股沟疝患者应用腹腔镜疝修补术与开放式无张力疝修补术的临床价值。方法回顾性选取2023年1—12月六枝特区人民医院收治的71例腹股沟疝患者的临床资料,根据手术治疗方法,将其分为观察组(n=37,腹腔镜疝修补术治疗)与对照组(n=34,无张力疝修补术)。比较两组手术相关指标、术后恢复情况、C反应蛋白(C-reactive Protein,CRP)、白细胞介素-6(Interleukin 6,IL-6)与并发症情况。结果观察组手术总用时、住院总时长、术中出血量为(90.62±15.76)min、(6.92±0.98)d、(62.33±10.51)mL,优于对照组的(105.47±22.32)min、(9.21±2.17)d、(67.81±11.53)mL,差异有统计学意义(t=3.213、5.647、2.095,P均<0.05)。观察组疼痛持续时间、首次下床时间与首次正常活动时间均优于对照组,差异有统计学意义(P均<0.05);观察组IL-6、CRP、并发症总发生率均低于对照组,差异有统计学意义(P均<0.05)。结论在成人腹股沟疝患者中,腹腔镜疝修补术有助于缩短手术及住院时间,减轻患者炎症反应,加快术后恢复速度,降低术中出血量及术后并发症风险。

腹腔镜经腹腹膜前疝修补术和开放式无张力疝修补术治疗腹股沟疝的效果对比

目的:对比腹腔镜经腹腹膜前疝修补术和开放式无张力疝修补术治疗腹股沟疝的效果。方法:选取2022年6月—2023年12月吴江区第四人民医院收治的腹股沟疝患者62例作为研究对象,随机分为观察组(n=31,腹腔镜经腹腹膜前疝修补术)与对照组(n=31,开放式无张力疝修补术)。比较两组围术期指标、临床疗效、应激指标及并发症发生率。结果:观察组手术时间、首次下床活动时间、住院时间均短于对照组,围术期出血量少于对照组,差异有统计学意义(P<0.05);观察组总有效率高于对照组,差异有统计学意义(P=0.002);术后,两组皮质醇(CORT)、醛固酮(ALD)、去甲肾上腺素(NE)水平高于术前,观察组CORT、ALD、NE水平低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P=0.037)。结论:腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的效果优于开放疝修补术,可缩短手术时间,减少出血量,促进术后恢复,有助于改善患者应激反应指标,提高临床疗效,安全性较高。

腹腔镜下经腹腔腹膜前疝修补术对腹股沟疝患者的影响

目的 研究腹股沟疝患者在腹腔镜下经腹腔腹膜前修补术后疼痛感受及手术切口舒适度的相关影响。方法 抽取2021年3月至2023年12月信阳市商城县上石桥镇中心卫生院收入的62例腹股沟疝患者进行回顾性分析,根据手术方式的不同分为A组与B组,各31例,A组接受开放式腹膜前间隙疝修补术,B组接受腹腔镜下经腹腔腹膜前疝修补术,两组术后疼痛、围术期相关指标、应激反应指标及切口满意度组间比较。结果 B组患者术后1 d、术后3 d及术后7 d疼痛评分均低于A组,差异有统计学意义(P <0.05);B组患者首次下床活动、术后疼痛持续时间及住院时间均短于A组,且术中出血量低于A组,差异有统计学意义(P <0.05),而两组患者手术用时相比,差异无统计学意义(P> 0.05);B组患者术后24 h肾上腺素(E)、皮质醇(Cor)及β-内啡肽(β-EP)水平均低于A组,差异有统计学意义(P <0.05);B组患者切口满意度高于A组,差异有统计学意义(P <0.05)。结论 对于腹股沟疝患者开展腹腔镜下经腹腔腹膜前疝修补术具有积极意义,其可有效缓解术后疼痛,提高切口满意程度,同时能有效降低术后应激反应,具有临床应用价值。

腹腔镜修补术与传统开放手术治疗腹股沟疝的效果对比研究

对比分析腹腔镜修补术和传统开放手术治疗腹股沟疝的效果。选取2021年9月-2023年9月中国人民解放军联勤保障部队第九二五医院收治的78例腹股沟疝患者为研究对象,随机将患者分为对照组和试验组,每组各39例,比较两组患者治疗效果。结果显示,试验组患者治疗总有效率高于对照组(P<0.05),并发症总发生率低于对照组(P<0.05),围术期相关指标均优于对照组(P<0.05)。术后,试验组患者各项应激指标、血清炎症指标均优于对照组(P<0.05)、心理状态评分和生活质量评分优于对照组(P<0.05)。研究发现,腹腔镜修补术治疗腹股沟疝效果明显,可减轻患者应激反应,改善患者心理状态,提高患者生活质量,降低并发症发生率,推广应用价值高。

腹腔镜完全腹膜外补片植入术治疗双侧腹股沟疝40例疗效分析

目的 总结腹腔镜完全腹膜外补片植入术(TEP)治疗双侧腹股沟疝的临床疗效。方法 分析2016年01月-2021年06月接受治疗的40例双侧腹股沟疝患者的临床资料,将其按照手术治疗的不同方式分为两组:观察组及对照组,观察组24例患者行腹腔镜完全腹膜外补片植入术,对照组16例患者行传统开放无张力疝修补术,比较两组患者的各项手术指标并统计两组患者术后并发症发生率及复发率。结果 观察组手术时间、术后住院时间明显短于对照组,差异具有统计学意义(P<0.05);观察组术中出血量(21.40±3.75)ml较对照组(21.21±3.70 ml)差异无统计学意义(P>0.05);观察组术后阴囊血清肿发生率及复发率均显著小于对照组,差异具有统计学意义(P<0.05)。结论 腹腔镜完全腹膜外补片植入术用于治疗双侧腹股沟疝具有明显优势,并有创伤小、术后疼痛轻、恢复快、术后并发症及复发率低。

比较单孔腹腔镜与传统开放手术治疗儿童腹股沟斜疝疗效

目的比较单孔腹腔镜与传统开放手术治疗儿童腹股沟斜疝疗效差异。方法回顾性选取2019年6月—2021年6月南宁市第二人民医院五象医院普外科收治的接受单孔腹腔镜疝修补术治疗的79例儿童腹股沟斜疝患儿作为腔镜组,同期采用传统开放手术治疗的53例儿童腹股沟斜疝患儿作为传统组。比较两组手术时间、手术出血量,术后住院时间、阴囊肿胀、切口瘢痕、复发率及满意率。结果腔镜组的手术时间、手术出血量、术后住院时间分别为(33.30±6.00)min、(2.05±0.28)mL、(2.58±0.98)d,均少于传统组的(60.26±11.81)min、(3.62±0.60)mL、(3.22±1.20)d,差异均有统计学意义(P<0.05)。腔镜组术后阴囊肿胀、术后瘢痕发生率分别为2.5%、1.3%,均低于传统组的11.3%、11.3%,差异均有统计学意义(P<0.05)。腔镜组与传统组术后复发率分别为1.3%、1.9%,满意率分别为98.7%、92.5%,两组比较差异无统计学意义(P>0.05)。结论与传统开放手术相比,单孔腹腔镜疝修补术治疗儿童腹股沟斜疝具有安全可靠、创伤小、恢复快、并发症少的优势,具有明显临床应有价值。

开放腹股沟疝无张力修补术后补片感染B超和CT联合诊断的应用价值

目的探讨开放式腹股沟疝无张力修补术后补片感染B超和CT联合诊断的应用价值。方法开放式腹股沟疝无张力修补术后确诊补片感染病人83例,术前均行B超和腹部CT检查,且以术中证实为确诊标准,比较B超、CT及其联合检查对开放式腹股沟疝无张力修补术后补片感染的诊断价值。结果83例病人中,B超诊断补片感染符合率75.90%(63/83);CT诊断补片感染符合率为86.74%(72/83),B超联合CT诊断诊断补片感染符合率为87.95%(73/83)。B超、CT、B超联合CT预判补片感染深度与手术中证实结果相比的准确度、灵敏度、特异度、Kappa值分别为88.76%、75.73%、90.58%、0.695;91.16%、80.96%、93.06%、0.774;91.97%、83.52%、93.64%、0.795。联合检查对诊断开放式腹股沟疝无张力修补术术后补片感染的应用价值优于单独超声检查和单独CT检查,差异有统计学意义(P<0.05)。结论B超联合CT诊断开放式腹股沟疝无张力修补术后补片感染的应用价值优于单独超声检查和单独CT检查。

TEP、TAPP与开放疝修补术治疗老年腹股沟疝的疗效比较

目的观察并比较完全腹膜外腹腔镜疝修补术(TEP)、腹腔镜经腹腔腹膜前补片植入术(TAPP)和开放疝修补术治疗老年腹股沟疝患者的疗效,为患者治疗该病症提供优选方案。方法回顾性选取2017年1月—2023年1月于安徽省铜陵市人民医院就诊的101例老年腹股沟疝患者的临床资料进行分析,根据不同手术方式将患者分为TEP组(35例)、TAPP组(26例)和开放组(40例)。观察并比较3组的围术期指标及术后康复、并发症发生情况;比较3组术后1个月生活质量评分。结果开放组的手术时间显著短于TEP组、TAPP组(均P<0.05);开放组术中出血量多于TEP组,而少于TAPP组(均P<0.05);TEP组手术时间短于TAPP组,术中出血量低于TAPP组(均P<0.05)。开放组术后肠功能恢复时间显著短于TEP组、TAPP组,但恢复正常活动时间、住院时间显著长于TEP组、TAPP组(均P<0.05);开放组术后疼痛评分显著高于TEP组、TAPP组(P<0.05);TEP组术后肠功能恢复时间短于TAPP组(P<0.05);开放组并发症发生率高于TEP组、TAPP组(均P<0.05),而TEP组并发症发生率略高于TAPP组,但差异无统计学意义(P>0.05);TEP组术后1个月生活质量各项评分均高于TAPP组、开放组(均P<0.05)。结论TEP、TAPP、开放疝修补术均为治疗老年腹股沟疝的安全有效方法,其中TEP术可减少患者手术创伤,促进患者术后肠功能恢复,提高其生活质量,安全性可靠,具有一定的临床应用价值。