A Clinical Controlstudy Of Laparoscopic Totally Extraparitoneal Prosthetic Versus Local Nerveblockade Anaesthesia For Tension-free Herniorrhaphy For Inguinal Hernia

Objective: By compare laparoscopic totally extraperitoneal inguinal hernia repair(Totally Extraperitoneal Prosthetic, TEP) with local nerveblockade anaesthesia fortension-free herniorrhaphy (local anesthesia open group) treatment for adult inguinalhernia, in order to explore reasonable and economy inguinal hernia repair. Methods: DateCollected fifty-two cases TEP (laparoscopic group) and fifty-six cases under localnerveblockade anaesthesia for tension-free herniorrhaphy (local anesthesia open group)from the First Affiliated Hospital of Xinjiang Medical University in January2010toDecember2011,to carried out the same period non-randomized concurrent controlstudy.We follow-up patients of two groups to compared patients’ preoperative andpostoperative parameters Postoperative.Results: Compared with the local anesthesia opengroup,the laparoscopic group presented langer operative time (99±20) min VS (56±17)min (t=11.955, P <0.01), postoperative ambulation activities time was lager (16±7) hVS (7±3) h,(t=9.912, P <0.01)]; postoperative hospital stay time was langer [(4±1) dVS (3±1) d (t=2.290, P <0.05)]; total duration of hospitalization was langer [(4±1) dVS (3±1) d,(t=2.087, P <0.05)]; the cost of hospitalization was higher than localanesthesia open group [(8958±413)RMB, VS (5354±397) RMB (t=46.202, P <0.01)].The postoperative complications of laparoscopic group (TEP group) presented five cases,namely: scrotum effusion1case, scrotum hematoma1case, incision hematoma1case,intestinal obstruction1case,1case appear chronic pain in the groin area；while in thelocal nerveblockade anaesthesia for tension-free herniorrhaphy (local anesthesia opengroup) ten cases of postoperative complications were happened, were as follows: effusionin3cases the scrotum, scrotum hematoma1case, wound infection in2cases, incisionhematoma in2cases, the groin area of chronic pain2cases. To compared withpostoperative complications and the incidence of complications,the two groups has nostatistically difference(χ~2=1.531,P>0.05). All cases were followed up for2~24months,the median follow-up time was13months. No case recurred in the two groupsduring that period.Conclusion: TEP as one of the tension-free inguinal hernia repairsurgery is more ideal, it was safe and effective,the operation is feasible for adult patients with inguinal hernia. while the local anesthesia tension-free repair of inguinal hernia havean unparalleled advantage the same, both of them in clinical practice are complementary.On the choice of surgical approach, physicians should be based on specific patients, toformulate appropriate individualized treatment plan, select the most optimized, and themost reasonable Surgical approach to obtain the best clinical and health economicsbenefits.