A Clinical Case-control Study Of Hernia Sac Management In TAPP

Objective:To investigate the clinical effect and postoperative complications of indirect inguinal hernia during laparoscopic preperitoneal repair.Methods:From September 2015 to August 2017,120 patients with herniorrhaphy less than 5 cm were analyzed in terms of blood loss,time of operation and time of getting out of bed after TAPP.Postoperative hospitalization time,postoperative scrotum emphysema,serum swelling,From September 2015 to August 2017,120 patients with hernia sac more than 5 cm were treated with TAPP.The amount of bleeding,the time of operation and the time of getting out of bed after operation were analyzed.Postoperative hospitalization time Cystic emphysema,serum swelling,infection and recurrence after operation.Results It was found that when the hernia sac was less than 5 cm,there was no significant difference between the complete exfoliation of hernia sac(2.420 ±0.209ml)and the transected hernia sac(2.420±0.203ml)by statistical t test.There was no significant difference between complete exfoliation of hernia sac(33.160 ±2.983min)and transected hernia sac(33.000±3.015min)compared with that of transected hernia sac(33.000 ±3.015min).The complete exfoliation of hernia sac was 7.280 ±0.810h and 7.060 ±0.59,respectively.There was no significant difference between the two groups by statistical t test at 7 h,and there was no significant difference between the two groups in the days of hospital stay after operation,complete exfoliation of hernia sac(4.060 ±0.753)days and transected hernia sac(3.960 ±0.785d).After operation,there was no significant difference between the two groups,but there was no significant difference between the two groups in postoperative scrotum emphysema and serum swelling.The statistical mathematical data x2 test showed that there was no significant difference between the two groups in wound infection and recurrence.The average intraoperative bleeding volume was 2.418 ±0.206 ml in the transection group and 4.644 ±0.444 in the complete exfoliation group when the hernia sac was larger than 5 cm.Ml,P<0.05),the mean operative time was 33.360 ±2.905 min in the transverse group and 46.000 ±3.753 min in the complete exfoliation group(P<0.05).The average time of getting out of bed in transection group was 7.051 ±0.559h.the average time of delamination group was 7.379 ±0.850h.there was significant difference between the two groups(P<0.05),and the average hospitalization time was 4.000 ±0.There was no significant difference between the two groups(P>0.05).The incidence of scrotal emphysema in the transection group was 2.6m,and the incidence rate of scrotal emphysema in the complete exfoliation group was 180.25%(P<0.05).The incidence of postoperative serum swelling in the transection group was 1 1.3%,and that in the complete exfoliation group was 79.7%(P<0.05),and the incidence of postoperative incision infection in the cross section group was 1.1%(P<0.05).There was no significant difference in the incision infection rate between the two groups(P>0.05),but there was no significant difference in the recurrence rate between the two groups(P>0.05),but the recurrence rate in the transection group was 2.6m,and the recurrence rate in the complete exfoliation group was 11.4%(P>0.05),and there was no significant difference between the two groups(P>0.05).Conclusion This experiment proved that the complete exfoliation of hernia sac and transected hernia sac were safe and effective.It is necessary to analyze the specific situation when the complete dissection or complete exfoliation of hernia sac.When the hernia sac is less than 5cm,the complete exfoliation should be recommended.Transection of hernia sac is recommended.in patients with indirect inguinal hernia whose hernia sac is larger than 5cm.