A Comparative Study Of Laparoscopic And Open Sublay Repair For Abdominal Wall Hernia

Objective:Abdominal hernia can be divided into primary and secondary hernia.Primary abdominal hernia is a disease of congenital internal abdominal tissue protrusion from the weak abdominal wall under the skin,such as umbilical hernia and abdominal white line hernia,etc.Secondary abdominal hernia is mostly a disease caused by iatrogenic trauma or destruction of abdominal wall structure,such as abdominal incisional hernia.Abdominal hernia is a disease that cannot heal itself and can only be solved surgically.With the improvement of technology,laparoscopic methods to solve abdominal wall hernia have been gradually used by a large number of surgeons.By observing the clinical effects of laparoscopic and open Sublay repair for abdominal wall hernia,this paper analyzed the advantages and highlights of laparoscopic complete extraperitoneal Sublay repair(TES)compared with open Sublay repair for abdominal wall hernia in the treatment of abdominal wall hernia.Methods: 1.Research subjects: Data of 38 patients with abdominal wall hernia admitted to Shaoxing Hospital of China Medical University from January 2015 to December 2020 were retrospectively analyzed,including10 patients with primary umbilical hernia and 28 patients with incisional abdominal wall hernia.22 patients received open Sublay repair,and 16 patients received TES.2.Observation indicators:patients’ age,gender,BMI,operative time,intraoperative blood loss,length of hospital stay and postoperative complications(incision infection rate,postoperative pain(VAS score),postoperative seroma,postoperative intestinal fistula,postoperative intestinal obstruction,postoperative recurrence,etc.).3.Statistical analysis:Retrospective analysis was used in this study,which was divided into open sublay group and TES group.SPSS25.0 statistical software was used to dispose the collected case data,and t test was used to dispose measurement data.χ2 test was used to dispose the count data,and when P <0.05,the difference was statistically significant.Results:Comparison between the TES group and the open sublay repair group: the comparison of basic data(gender,age,BMI)between the two groups showed no statistically significant difference.In terms of hospital stay,incision infection rate and postoperative pain(VAS score),the difference was statistically significant.The operative time was significantly higher than that of the open sublay repair group,and the difference was statistically significant.However,there were no significant differences in hospitalization cost,intraoperative blood loss,postoperative seroma,postoperative intestinal fistula and postoperative recurrence,and the differences were not statistically significant.This study is a retrospective study,the principle of random,not being completely and small sample size of cases cases sample years span longer,surgery performed by different doctors,surgical technique and experience different,less complications of meaningful results,there are certain deviation,the results of research on partial migration may occur.Therefore,it is necessary to conduct clinical randomization studies with a large number of samples.Conclusion: 1.In the treatment of abdominal wall hernia,both open abdominal wall hernia repair and laparoscopic abdominal wall hernia complete extraperitoneal Sublay repair are safe and effective.2.According to the results of this study,Although laparoscopic surgery takes longer than open surgery,TES has the advantages of small incision,low risk of incision infection,less postoperative pain and shorter hospital stay.3.Sublay repair of open abdominal wall hernia is widely used in the treatment of abdominal wall hernia,and the technique is mature.And TES surgery is difficult,for general surgery doctor’s test and challenge,because it requires surgeon has solid knowledge of anatomy and mature laparoscopic technique,but still no matter in beautiful,minimally invasive surgery success rate is better than the open surgical repair of abdominal wall hernia sublay,physicians should according to their own technology and the patient’s individual situation,choose the suitable operation,in order to achieve the best treatment,bring more satisfaction to the patient.