Clinical Controlled Study Of Three Kinds Of Open Tension-free Hernia Repair In Treatment Of Adult Inguinal Hernia

BackgroundInguinal hernia is a common disease in general surgery, inguinal hernia repair isalso one of the oldest and most common surgical approach.To look at the developmentof hernia surgery it undergone major anterior tension-free repair, open tension-freerepair and foundation repair without tension laparoscopic hernia repair on developed inthree stages. due to the presence of a higher incidence of postoperative complicationsand recurrence rate of the traditional hernia repair tension, now largely having beenabandoned by clinical, due to the high cost of hospitalization and technical difficulty ofthe new laparoscopic,which is difficult to spread, open tension-free hernia repair has tobecome the vast majority of physicians recognized and preferred surgical approach.Open tension-free repair was developed in the late20th century, a kind ofbio-synthetic material, Using which to strengthen the posterior wall of the inguinalcanal. The current commonly methods are Lichtenstein,Rutkow and TEP open surgery.Such approach not only to overcome the traditional surgical approach,whichinterference anatomy of normal tissuenormal, and in line with the physiologicalmechanism of the human body,levels more clear, no tension in involutionandsuture,there will no the feeling of tension surrounding tissue lesions in patients withpost-surgical pain. With clinical applications and research of open tension-free repair inthe treatment of inguinal hernia, which has been fully affirmed the superiority.The open tension-free repair as Lichtenstein,Rutkow and TEP, comparing withtraditional hernia repair has the following advantages: a wide range of surgicalindications, tissue injury, shorter operative time, postoperative pain, faster recovery, relapse rate, postoperative complication rate. Specific three surgical Which is better, avariety of literature and clinician perspectives differences, based on the above issues,access to a large literature and clinical cases were analyzed, and found that these threetension-free hernia repair in the treatment of adult groin hernia are valid methods havetheir own advantages, but there are also their disadvantages.PurposeTo compare the effect of the treatment of adult inguinal herniaopen amongLichtenstein, Rutkow and TEP. Combining with relevant literature and surgical cases, toexplore the open tension-free hernia repair in the treatment of adult inguinal herniasurgery in a more rational way, and to analyze their respective strengths and weaknesses,to provide a basis for the treatment of adult inguinal hernia.Materials and methodsTo Collect786cases of hernia patients by the same group physician in our hospitalin March2008-2013, Lichtenstein378cases,Rutkow322cases and open TEP surgerywas86cases. To compare surgical operative time, postoperative hospital stay,postoperative recovery time, hospital costs, postoperative complications among threegroups, access to relevant information by referring cases, outpatient follow-up andtelephone follow-up, recording data, use SPSS13.0statistical package for statisticalanalysis.Results1) Lichtenstein, Rutkow and TEP,three groups of the mean operative time were34±4min,35±7min,36±8min, the average length of hospital stay were4.7±0.32d,5.1±0.25d,4.2±0.27d, the average recovery time after surgery were6.7±1.5d,7.2±1.7d,6.5±0.1.4d, the average total cost of treatment were6324±527yuan,7634±329yuan,8112±524yuan, the difference was no statistically significant(P>0.05) between the three kinds of surgical procedures.2) Groin pain in postoperative complications among the three groups were different(P<0.05). Open TEP group was significantly less than the other two groups, and Lichtenstein group was the highest, following Rutkow group3) Wound infection, nerve paresthesia, scrotal edema in the open TEP group weresignificantly less than the other two groups (P<0.05).4) Open TEP group7cases, Lichtenstein group of8patients, Rutkow7cases withpostoperative complications seroma, TEP group was higher than the other twogroups, the difference was statistically significant (P<0.05),but there was nodifference in Lichtenstein group and Rutkow groups (P>0.05).5) There was no difference in postoperative recurrence of the three groupsConclusion1). Lichtenstein, Rutkow, TEP, Three species of open tension-free hernia repair has ashorter operative time, postoperative recovery, relapse rate, etc., are the treatment ofchoice adult inguinal femoral hernia surgery.2). Three kinds of open tension-free hernia repair inguinal hernia treatment of adultshave their own advantages, according to the specific circumstances, weighing the prosand cons to merit it.3). Open TEP group groin pain in postoperative complications, wound infection, nerveparesthesia, scrotal edema has advantages in terms of postoperative complications wassignificantly higher seroma other two groups.