Comparison of the effect of laparoscopic totally extraperitoneal herniorrhaphy and transgastric abdominal pre-peritoneal herniorrhaphy in the treatment of unilateral primary inguinal hernia in adults
ZHANG Minjian1 WU Yongyou2 ZHONG Fengyun2 WU Weibing1 LI Jia1
1.Department of General Surgery, Taicang Hospital of Traditional Chinese Medicine, Jiangsu Province, Taicang 215400, China;
2.Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Soochow University, Jiangsu Province, Suzhou 215004, China
Abstract：Objective To compare the clinical effect of laparoscopic totally extraperitoneal herniorrhaphy (TEP) and transgastric abdominal pre-peritoneal herniorrhaphy (TAPP) in the treatment of unilateral primary inguinal hernia in adults. Methods A total of 82 patients with unilateral primary inguinal hernia admitted to Taicang Hospital of Traditional Chinese Medicine in Jiangsu Province from May 2019 to June 2021 were selected as the research objects. They were divided into TEP group (receiving TEP treatment) and TAPP group (receiving TAPP treatment) by random number table method, with 41 cases in each group. Operation-related indexes, hospitalization costs, blood gas changes (the difference of partial pressure of carbon dioxide in arterial blood [ΔPaCO2] before and after surgery, the difference of the intraoperative maximum of transcutaneous monitoring of partial pressure of end-tidal carbon dioxide [TcCO2] and the preoperative TcCO2 [ΔTcCO2], the time to reach the maximum TcCO2 [Tmax]), postoperative pain, postoperative complications, and recurrence six months after surgery were compared between the two groups. Results Operating time and Tmax in TEP group were shorter than those in TAPP group, hospitalization cost was lower than that in TAPP group, ΔPaCO2 and ΔTcCO2 were higher than those in TAPP group, and the differences were statistically significant (P＜0.05). There were no significant differences in intraoperative blood loss, length of hospital stay, duration of pain, 24 h postoperative visual analog scale score, total incidence of postoperative complications, and recurrence rate at six months after surgery between the two groups (P＞0.05). Conclusion TEP is superior to TAPP in terms of surgical time and hospitalization cost, and TAPP has advantages in reducing carbon dioxide in vivo during surgery. The two surgical methods are similar in the treatment of postoperative pain in adults with unilateral primary inguinal hernia, and both are safe and effective.
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