Comparison Of The Efficacy Self-gripping Mesh And Medical Glue+3DMax Mesh In Laparoscopic Transabdominal Preperitoneal Hernia Repair

Objective: Comparing the efficacy of self-gripping mesh and medical glue+3DMax mesh for hernia repair by using Laparoscopic transabdominal preperitoneal hernia repair technique.Methods: A retrospective analysis of 225 cases of laparoscopic inguinal hernia repair(TAPP)between August 2018 and December 2019 in the department of Gastroenterlogy Surgery,the Affiliated Hospital of Southwestern Medical University.The cases were divided into self-gripping group and medical glue group(glue group+3Dmax mesh)by the differences of mesh fixation and the differences of mesh implantation,including 116 in the self-gripping group and 109 in the medical glue group.The data,including age,gender,the type of hernia,BMI,whether have the basic diseases(hypertension,diabetes and chronic bronchitis),operative time,intraoperative blood loss,postoperative hospital stay,short-term postoperative complication(seroma,incision infection and urinary retention),postoperative pain(1day,2 days and 7 days,estimate by VAS score),chronic pain,mesh infection,atrophy or necrosis of testis and recurrence.Results: There were no significant differences between the two groups of patients in age,gender,type of hernia,body mass index,preoperative basic diseases(P > 0.05).The average operation time of the medical glue group[(58.59±16.27)min] was longer than the self-gripping group [(55.90±12.91)min],however,without statistically significant.There were no significant differences in intraoperative blood loss,and postoperative hospital stay between the two groups.In terms of postoperative short-term complications,there were no puncture infection,surgical infection.There were 7 cases and 5 cases urinary retention in the medical glue group and self-gripping group respectively and there was no significant difference in urinary retention(P>0.05).The incidence of seroma in the medical glue group was significantly higher than that in the self-gripping group [13(11.2%)vs 4(3.6%)],the difference was statistically significant(P=0.033);There was no statistically significant difference in pain assessment(VAS score)in the operation area between the medical glue group and the self-gripping group after the 1st,2nd,7th postoperative period(2.65±0.82 VS 2.61±0.73,1.97±0.84 VS 1.92±0.81,and 0.85±0.46 VS 0.80±0.48,respectively,P<0.05).By measure the interaction between the two groups,different time was statistically significant(P<0.001),but different group and time with group were no statistically significant(P> 0.05),the pain in the medical glue group was no significantly relieved compared with the self-gripping group.There were no mesh infection,atrophy or necrosis of testis and recurrences in the two groups at 6-12 months after surgery.There were 5cases and 6 cases chronic pain in the medical glue group and self-gripping group respectively and there was no significant difference(P>0.05).Conclusion: In laparoscopic transabdominal preperitoneal hernia repair,self-gripping mesh or 3DMax mesh + medical glue can achieve good results.Compared with 3DMax mesh + medical glue,self-gripping mesh can effectively reduce the incidence of seroma after TAPP without additional complications and save medical cost.