| Background:Day surgery is a new diagnosis and treatment mode,in which patients compiete surgical treatment of related diseases within 24 hours after admission and are discharged on the same day.Laparoscopic transabdominal preperitoneal hernia repair has the advantages of little interference to the body's physiological function and relatively small operation risk.Various hospitals in China have been widely used in the ireaiment of inguinal hernia under the day surgery mode,which has achieved good(?)urative effect.Laparoscopie transabdominal preperitoneal hernia repair usually adopts dissection or transection to treat hernial sac.However,the choice of the two methods has been controversial for a long time and there is no definite conclusion.Therefore.m this study,we compare the incidence of postoperative complications and recurrence in laparoscopic transabdominal preperitoneal hernia repair under day surgery mode,discuss the causes and take effective preventive measures to provide guidance for clinicians to choose the best treatment method for hernial sac.Methods:Seventy-eight patients with inguinal hernia,treated in our hospital during the day surgery mode from August 24,2016 to October 24.2018.were selected by retrospective analysis.All patients were treated with laparoscopic transabdominal nmtoneal hernia repair under day surgery mode,which was completed by experienced general surgeons.According to the treatment method of hernial sac during operation,32 patients who underwent transverse treatment of hernial sac were divided into group T,and 46 patients who underwent dissection of hernial sac were divided into group D.There should be no significant difference in age,sex,disease type,body mass index and other basic data between the two groups(p>0.05).Regular telephone inquiries or outpatient follow-up were used to make statistics on the operation time.intraoDerative blood loss,operation success rate,hospitalization time,postoperative complications(urinary retention,groin pain,serum swelling:etc.)and hernia recurrence of the two groups of patients,and the data were compared and analyzedResults:All 78 patients successfully completed the operation without recurrence.Compared with the two groups of patients treated by laparoscopic transabdominal preperitoneal hernia repair under daytime operation mode,the operation time of the transection group is shorter than that of the dissection group(52.500±14.03 vs 61.61±19.53),and the difference in operation time between the two groups is statistically significant(p<0.05).The intraoperative blood loss in the transection group was less than that in the dissection group(7.66±2.84 vs 9.13±3.22),and the difference between the two groups was statistically significant(p<0.05).There was no significant difference in the incidence of postoperative serum swelling,groin pain,urinary retention and total complications between the two groups(p>0.05).Using visual analogue scale to reflect the degree of pain,the incidence of postoperative groin pain scores between 0-3 and 4-6 zones in the t-wo groups had no significant difference(p>0.05).There was no significant difference in postoperative groin pain score and duration between the two groups(p>0.05)Conclusion:Laparoscopic transabdominal preperitoneal hemioplasty is safe and feasible for inguinal hernia under dav surgery mode,and transection or dissection of hernial sac during operation is an effective treatment method.In the day surgery mode mode,transverse treatment in laparoscopic transabdominal preperitoneal hernia repair can shorten the operation time and reduce the amount of bleeding during the operation compared with stripping treatment of hernial sac.The difference of complications and recurrence after transection or dissection of hernial sac in laparoscopic transabdominal preperitoneal hernia repair under day surgery mode may require more central and large samples of clinical data to confirm. |
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