Abstract:

Objective　To investigate the efficacies of laparoscopic transabdominal preperitoneal hernia repair and open mesh repair in the treatment of occult inguinal hernia. Methods　A total of 96 patients with occult inguinal hernia admitted to Affiliated Hospital of Jining Medical University from October 2021 to October 2022 were divided into a conventional group (48 cases) and an observation group (48 cases) according to the random number table method. The age of the conventional group was (63.85±5.65) years old, and that of the observation group was (64.85±5.87) years old. The conventional group was treated with open mesh repair, and the observation group was treated with laparoscopic transabdominal preperitoneal hernia repair. The intraoperative blood loss and length of hospital stay were compared between the two groups, the pain scores before and after treatment were compared between the two groups (Prince-Henry pain score was used to evaluate the degree of pain before and 12 h after treatment), and the urodynamics before and after treatment and complication rate were compared between the two groups. t test and χ² test were used. Results　The intraoperative blood loss in the observation group was less than that in the conventional group [(32.54±3.25) ml vs. (39.63±4.85) ml] (t=8.414, P<0.001), and the length of hospital stay was shorter than that in the conventional group [(6.87±0.63) d vs. (8.25±1.12) d] (t=7.440, P<0.001). There was no statistically significant difference in the Prince-Henry pain score between the observation group and the conventional group before surgery [(3.89±0.58) points vs. (3.85±0.52) points] (t=0.356, P=0.723); the Prince-Henry scores of both groups were decreased 12 h after surgery, and the Prince-Henry score of the observation group was lower than that of the conventional group 12 h after surgery [(1.50±0.61) points vs. (2.96±1.42) points] (t=6.545, P<0.001). Before treatment, there were no statistically significant differences in the bladder compliance and bladder volume during urgent urination between the two groups (both P>0.05); after treatment, the bladder compliance and bladder volume during urgent urination were increased in both groups (all P<0.05), and the bladder compliance and bladder volume during urgent urination in the observation group were higher than those in the conventional group (both P<0.05). The incidence of complications of the observation group was lower than that of the conventional group [6.25% (3/48) vs. 20.85% (10/48)] (χ²=4.360, P=0.037). Conclusion　Laparoscopic transabdominal preperitoneal hernia repair can improve the recovery in patients with occult inguinal hernia, relieve the pain, improve the urodynamics, and reduce the incidence of complications, which is worthy of clinical promotion and application.

Key words:

Occult inguinal hernia, Laparoscopic transabdominal preperitoneal hernia repair, Open mesh repair, Urodynamics, Bladder volume during urgent urination, Complications

摘要：

目的　探讨腹腔镜经腹腹膜前疝修补术与开放补片修补术治疗隐匿性腹股沟疝的疗效。方法　选取2021年10月至2022年10月济宁医学院附属医院收治的96例隐匿性腹股沟疝患者，按照随机数字表法分为常规组48例、观察组48例。常规组年龄（63.85±5.65）岁，观察组年龄（64.85±5.87）岁。常规组给予开放补片修补术治疗，观察组给予腹腔镜经腹腹膜前疝修补术治疗。对比两组术中出血量和住院时间，对比两组治疗前后疼痛感评分（于术前、术后12 h采用Prince-Henry疼痛评分评价疼痛程度），对比治疗前后两组尿动力学以及并发症发生率。采用t检验、χ²检验。结果　观察组术中出血量（32.54±3.25）ml少于常规组（39.63±4.85）ml（t=8.414，P<0.001），住院时间（6.87±0.63）d短于常规组（8.25±1.12）d（t=7.440，P<0.001）。术前观察组、常规组患者Prince-Henry疼痛评分比较［（3.89±0.58）分比（3.85±0.52）分］，差异无统计学意义（t=0.356，P=0.723）；两组患者术后12 h Prince-Henry评分均降低，观察组术后12 h Prince-Henry评分低于常规组［（1.50±0.61）分比（2.96±1.42）分］（t=6.545，P<0.001）。治疗前，两组膀胱顺应性、急迫尿意时膀胱容量对比差异均无统计学意义（均P>0.05），治疗后两组患者膀胱顺应性、急迫尿意时膀胱容量均升高（均P<0.05），且观察组膀胱顺应性、急迫尿意时膀胱容量高于常规组（均P<0.05）。观察组并发症发生率低于常规组［6.25%（3/48）比20.85%（10/48）］（χ²=4.360，P=0.037）。结论　隐匿性腹股沟疝患者采用腹腔镜经腹腹膜前疝修补术治疗能够促进恢复，缓解疼痛，有利于改善患者的尿动力学，降低并发症发生率，值得在临床中推广与应用。

关键词:

隐匿性腹股沟疝, 腹腔镜经腹腹膜前疝修补术, 开放补片修补术, 尿动力学, 急迫尿意时膀胱容量, 并发症