Observation Of Clinical Effect Of Different Surgical Repair Of In The Inguinal Hernia Treatment Of Adult Male In Primary Hospital

Objective: To comparatively research the clinical effect and complication of open tension-free hernia repair(Rutkow)transabdominal preperitoneal(TAPP),and totally exntraperitoneal prosthesis(TEP)in the treatment of adult inguinal hernia in primary hospital.Materials and methods: Retrospective analysis 316 patients treated in our hospital from January 2014 to December 2016.149 cases(single side)of patients operated by the same chief physician were selected and divided into three groups according to the different operation methods,the open tension-free hernia repair(77 cases),the TAPP group(37cases),and the TEP group(35cases).All patients performed successfully,without serious complications,without recurrence in the follow-up period.The operation time,the pain score at first day of postoperative,the hospitalization cost,length of stay,postoperative complications of three groups were observed.After 6 months follow up,the recurrence of two groups were observed.Results: Open tension-free herniorrhaphy(Rutkow)is main inguinal hernia repair in our hospital while the proportion of laparoscopic inguinal hernia repair(TAPP,TEP)has gradually increased.Both groups obtained a better curative effect,the operation time in the open tension-free group was were obviously shorter than those in the group TAPP and TEP,and the length of stay in open tension-free group(11±4.10d)was obviously longer than those in the group TAPP(10±4.45d)and TEP(9±2.74d),while the hospitalization cost in open tension-free group(8619±1777.66 yuan)was were obviously lower than those in the group TAPP(14322±2131.13 yuan)and TEP(14322±2131.13 yuan),and the difference was statistically significant(P<0.001),and the postoperative pains in the TAPP and TEP was obviously lower than that in the open tension-free group and the difference was statistically significant(P<0.001).Incidence of postoperative urinary retention: open group > TEP group> TAPP group.Incidence of Subcutaneous emphysema: TEP group>TAPP group>open group.Other postoperative complications were not statistically significant in three groups.Conclusion: The laparoscope and open tension-free hernia repair are the safe and effective operation methods.Open tension-free was has the shorter operation time and it is more economical.While TAPP and TEP can significantly reduce the degree of postoperative pain,shorten the length of stay,reduce postoperative urinary retention,chronic pain or numbness.