Comparative Study On Laparoscopic Inguinal Hernia Repair And Open Mesh-plug In Tension Free Hernia Repair

Background and ObjectiveInguinal hernia is a common disease.The surgery therapy of inguinal hernia had experienced several stages: traditional repair, low tension hernia repair, tension-free hernia repair(the major format is mesh—plug in tension free hernia repair)and laparoscopic inguinal hernia repair(the major format is transabdominal preperitoneal TAPP). The two later operations are new formats in reccent years, which have advantages over traditional repair in effect and have been the popularized operations in inguinal hernia repair because of little ravage, quick recovery, few complication and low recurrence rate. However now there are few comparative reports between those two formates, and the most reports are limited in clinic and follow-up survey, offering weak persuasive conclusion. there is contentious about which is more advantaged. We compared the two operation and postoperative results, especially more objective laboratory index—WBC,CRP,IL-6, which can reflect the infection and stress reaction in body after operation in order to discuss the superiority, deficiency and indication of those two formates, provide scientific and objective reference to general sergeons and patients.Method50 patients in the First Affiliated Hospita of Zhengzhou University were selected as investigated objects. 25 patients ( group A ) were repaired with TAPP, 25 cases ( group B ) were repaired with mesh—plug in tension free hernia repair. Compare and analyse the two operation and postoperative results and follow-up survey one year after operation. The vital point : (1) laboratory index: WBC, CRP, IL-6; (2) clinic index: operation time, duration time in hospital, pain lasting time, normal activity time, complication, et al; (3) follow-up survey index: normal work time, disappeared time of inguinal discomfort, spermary atrophy and hernia recurrence, et al. t-test was used to analyze the quantity data and x~2 test was used to analyze the quality data by the SPSS 13.0 statistic soft ware pack.ResultsAfter operation WBC, CRP, IL-6 of all patients increased(P<0.05). Between those two groups, IL-6'increasing in group A is distinct compared with group B(P< 0.05)at 4 hours and 1 day after operation. The difference of the other laboratory indexs have no statistics meanings. Duration time in hospital, the first activity time under bed, normal activity time, normal work time, pain lasting time in group B are shorter than those in group A(P<0.05). Operation time, price in hospital in group B are shorter(P<0.05). There are 6 cases with skin or scrotum emphysema in group A, whereas 0 cases with those complications in group B(P<0.05). The difference of the other clinic indexs have no statistics meanings. Besides normal work time, the other difference of follow-up survey indexs have no statistics meanings. During one year after operation, no case appear hernia recurrence in two groups after one year.ConclusionMesh—plug in tension free hernia repair and laparoscopic inguinal hernia repair are both preponderant in little ravage, few complication and low recurrence rate. The formor with shorter operation time and little price in hospital, suits the first operation patients. The later has little stress reaction, shorter pain lasting time and duration time in hospital after operation, so it suits recurrence hernias, double sides hernias and old patients with inguinal hernia. but it has the shortercoming of inhalation anesthetics and long learning time.