The Clinical Research Of Laparoscope Inguinal Hernia Repair

Objective:To evaluate the efficacy and the clinical application value ofIntraperitoneal Onlay Mesh and Preperitoneal Onlay Mesh; To compare the cost andeffectiveness of Transabdominal and Totally Extraperitoneal laparoscopic repair.Methods:From June2010to June2012, the clinical data of138cases laparoscopeinguinal hernia repair were analyzed retrospectively.91cases underwent IntraperitonealOnlay Mesh,27cases underwent Transabdominal Preperitoneal and20cases underwentTotally Extraperitoneal. The general information, data of operations, postoperativehospitalization days, complications, rate of recurrence were collected for comparison ofLaparoscopic Inguinal Hernia Onlay Mesh in different spaces; The direct cost foroperations, drugs, nutritional support, days of hospitalization, treatment for postoperativecomplications and reoperations was prospectively evaluated; the indirect cost and the totalcost were collected for analysis of investigation of the availability of the heath careresources. Results:Compared with Intraperitoneal Onlay Mesh group, PreperitonealOnlay Mesh group had significantly lower rate of chronic pain [0case vs.15cases, P=0.003], higher rate of seroma [0case vs.4cases, P=0.027], No significant differenceexists between the two groups in the infection, sensory dysfunction, scrotal hematoma,recurrence, and average postoperative hospital stay (all P＞0.05); Compared withTransabdominal Preperitoneal group, Totally Extraperitoneal group had significantlyhigher cost of anesthetization [1061RMB (850~1267) vs.918RMB (730~1180), Z=-2.153,P=0.031], lower cost/effectiveness [16135.37RMB vs.17710.85RMB]. There were nosignificant statistical difference between the two groups in the average postoperativehospital stay[(3.4±1.0)d vs.(3.2±0.8)d，t=0.736，P=0.465], complications[0vs.1，P=0.426], recurrence[1vs.1，P=0.675]. No significant difference exists between the twogroups in the cost of direct medical, check, medicines, operation, Hospitalization, nursingand diagnosis, indirect medical, total (all P＞0.05). Conclusion:Intraperitoneal Onlay Mesh and Preperitoneal Onlay Mesh were two kinds of safety and effectively methods forthe treatment of Inguinal hernia; Two groups are similar effectiveness in treating inguinalhernia; Totally Extraperitoneal group has higher cost-effectiveness results compared toTransabdominal Preperitoneal group.