Clinical Comparative Study Of Laparoscopic And Open Inguinal Hernia Repair

Objective:Through a retrospective clinical comparative study of laparoscopic inguinal hernia repair and open inguinal hernia repair,the advantages and disadvantages of two kinds of surgical treatment for inguinal hernia were further clarified.It can be used for reference in the selection of surgical procedures for routine inguinal hernia diagnosis and treatment.Methods:Methods a retrospective analysis of 78 cases of inguinal hernia in Department of general surgery,Affiliated Hospital from Sep,2015 to Oct,2017 was carried out.According to certain inclusion and exclusion criteria,relevant cases were selected.They were divided into two groups according to different operative methods:endoscopic group(38 cases)and open group(40 cases).The general clinical characteristics of the two groups of patients,such as age,sex,BMI index,anatomical classification of inguinal hernia and lesion type,were not statistically significant(P>0.05),and were comparable.Statistical comparison and analysis of the two groups of patients during and after operation:operation time(min),intraoperative hemorrhage(ML),postoperative bed time(H),hospitalization days(d),hospitalization expenses(yuan),postoperative pain,nerve injury,peritoneum rupture,scrotal gas,urinary retention,preperitoneal hemorrhage,serum swelling,incision infection,chronic pain,recurrence,patient full.Meaning and so on.Results:The mean operative time in the laparoscopic group and the open group was 72.24 +10.89min and 56.75 + 8.26min respectively.The P value was less than 0.05,and the difference was statistically significant.That is to say,the operation time of the two groups is:laparoscopic group>open group.The average bleeding volume in the laparoscopic group and the open group was 25 + 9.21ml and 48 + 12.5ml respectively.The P value was less than 0.05,and the difference was statistically significant.The average bleeding volume in the two groups was:laparoscopic group<open group.The average time of getting out of bed in laparoscopic group and open group was 14.32 + 2.98h and 28.98 + 3.78h.The P value was less than 0.05,and the difference was statistically significant.That is to say,the average time of getting out of bed in two groups is:laparoscopic group<open group.The average length of stay in the laparoscopic group and the open group was 5.23 + 1.03d and 8.43 + 2.12d respectively.The P value was less than 0.05,and the difference was statistically significant.That is to say,the average hospitalization time of two groups is:laparoscopic group<open group.The average hospitalization expenses in the laparoscopic group and the open group were 12479 + 710.71 and 8294 + 443.12 respectively.The P value was less than 0.05,and the difference was statistically significant.That is,the average hospitalization cost of the two groups is:laparoscopic group>open group.The number of patients with different pain degree at the time of 12,24 and 72 after operation were compared with those in the laparoscopic group and the open group.The chi square values were 7.144,8.621 and 9.382 respectively.The corresponding P values were all less than 0.05,and the difference was statistically significant.Postoperative pain degree:laparoscopic group<open group.In the two groups,2 cases of peritoneum rupture were found in the laparoscopic group,the incidence rate was 5.3%(2/38),1 cases were scrotal gas accumulation,the incidence rate was 2.6%(1/38),and the incidence of 1 cases of seroma was 2.6%(1/38).There were 1 cases of nerve injury in the open group,with a incidence of 2.5%(1/40),one case of urinary retention,2.5%(1/40),1 cases of preperitoneal hemorrhage,2.5%(1/40),2 cases of serum swelling,5%(2/40),1 incisional infection,2.5%(1/40),1 cases of chronic pain,and 2.5%(1/40).There was no recurrence in the two groups at present.A single complication was analyzed by chi square test.The P value was greater than 0.05,and the difference was not statistically significant.However,the total number of complications occurred in comparison with P value less than 0.05,the difference was statistically significant.The total incidence of complications:laparoscopic group<open group.The patients in the laparoscopic group were satisfied.4 patients in the open group were not satisfied,the X2 value was 4.005,and the P value was less than 0.05,the difference was statistically significant.Two groups of patients satisfaction:laparoscopic group>open group.Conclusion:Endoscopic herniorrhaphy was longer than open hernia repair,and the total cost of hospitalization was higher than that in the open group,but the amount of intraoperative bleeding and postoperative pain were superior to the open type.There was no significant difference in the occurrence probability of single complication and recurrence rate,and the total incidence rate was slightly different.In conclusion,the two operation methods can enhance the requirement of pubis muscle hole weakness,play a therapeutic role,and patients recover faster after operation,and have fewer postoperative recurrence.In clinical,the choice of surgical methods should also be combined with the individual pathological factors and economic conditions,comprehensive consideration and evaluation,to provide more appropriate surgical methods for the patients.