| Background:The external abdominal hernia refers to protrusion of an organ or a tissue in abdominal cavity,coupled with parietal peritoneum,through a weak point or hole in the abdominal wall that usually contains it.And an inguinal hernia is a bulge of abdominal-cavity contents through the inguinal region,which turns out to be one of the most common surgical diseases with tens of millions of patients worldwide receiving inguinal hernia repair surgery annually.Laparoscopic inguinal hernia repair primarily features the use of prosthetic material for the coverage of myopectineal orifice and the overlap with surrounding tissues to strengthen abdominal wall.Laparoscopic surgery has been more widely used for hernia repair than open surgery due to its advantage of small incisions.Affected by natural orifice transluminal endoscopic surgery(NOTES),single inci-sion laparoscopic surgery(SILS)with "smaller incisions" has revolutionized the way basdon well-developed traditional laparoscopic surgery in recent years.While whetherit is fail-safe to apply SILS into the field of hernia repair or whe ther SILS cane-ven bring about more advantages than old-fashioned surgery rem ains to be sen.This study seeks to move into the deeper water to probe into this problem.Objective: The single-hole and porous laparoscopic total extraperitoneal inguinal hernia repair were compared to confirm that whether single-hole TEP the similar or better clinical efficacy than porous laparoscopic inguinal hernia repair?Methods: The clinical data of 26 single-hole TEP and 34 traditional porous TEP during from September 2016 to November 2018 were analyzed.With an average age of(56 ±13)years,the single-hole TEP group ranges from 31 to 79 years old,empassing 2female patients and 24 male patients who can be placed into three parts according to the types of hernia: 20 patients with indirect inguinal hernia,5 patients with direct inguinal hernia and 1 patient with direct & indirect inguinal hernia.With an average age of(59± 12)years,the porous TEP group includes 33 male patients and 1 female patients ranging from 33 to 85 years,out of which there are 28 patients with indirect inguinal hernia,5 patients with direct inguinal hernia and 1 patient with direct & indirect inguinal hernia.Merely affected by unilateral inguinal hernia,all patients in both groups are free from obvious mental or organic diseases,without complicated cases such as hernia recurrence,irreducible hernia,incarcerated hernia.The single-hole and porous TEP was studied to investigate the difference of them including the operation time,intraoperative blood loss,change TAPP or open,intestinal damage,postoperative wound infection,with or without seroma,24 hours postoperative pain score,chronic pain during more than one month,incision healing satisfaction,urinary retention,recurrence,late or late patch infection,hospitalization time,and total hospitalization expenses.Results: The length of surgery in the single-hole group(84±22 min)was longer than that in the porous group(65±28 min),which showed statistically significant differences.The pain score of single hole group(1.8±1.1)was lower than that of the porous group(2.7±1.4)at 24 hours after operation,but the wound healing satisfaction of single hole group(9.7±0.3)was significantly higher than the porous group(8.6±0.6).Moreover,there were not statistically significant differences between the two groups in intraoperative blood loss,postoperative incision infection,seroma,chronic pain within one month,urinary retention,hospital stay,and total hospitalization costs.In addition,there was not recurrence or delayed patch infections existed in either group.Conclusions: Single-hole TEP is safe and effective,and the incision pain is milder.Thepatient's satisfaction with the surgical incision is higher than that of the porous TEP.There were not statistically significant differences between the two groups in intraoperative complications,postoperative complications,hospital stay,and hospitalization costs. |
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