Clinical Comparative Study of Laparoscopic TransabdominalPreperitoneal Prosthesis (TAPP) with Different Methods of Closure of Direct Hernia Defect
ZHONG Gang,ZHANG Nan
Department of Gastrointestinal and Hernia Surgery, Tianjin Nankai Hospital, Tianjin 300100, China
Abstract:
Objective To compare the clinical ef?cacy and safety of three different methods in the closure of direct hernia defect in transabdominal preperitoneal prosthesis (TAPP).Methods The clinical data of 116 patients who underwent laparoscopic transabdominal preperitoneal prosthesis from June 2018 to December 2019 were analyzed retrospectively. According to the different methods of closure of direct hernia defect, they were divided into endoloop group, suture group and staple ?xation group. The size of direct hernia defect, intraoperative time, pain score on the ?rst day after operation and the incidence of postoperative complications were compared among the three groups. Results There was no signi?cant difference in the size of direct hernia defect between the endoloop group and the suture group (P=0.08), but the direct hernia defect in the endoloop group and the suture group was smaller than that in the staple ?xation group, which the difference was statistically signi?cant (P<0.001). There was no signi?cant difference in the intraoperative operation time between the endoloop group and the staple ?xation group (P=0.84), but the intraoperative operation time in the endoloop group and the staple ?xation group was signi?cantly lower than that in the suture group (P<0.001).There was no signi?cant difference in pain score on the ?rst day after operation among the three groups (P= 0.23).For the occurrence of postoperative complications, there was no signi?cant difference in the incidence of seroma among the three groups (χ2= 0.78, P=0.89), and there was no signi?cant difference in the incidence of recurrence among the three groups (χ2=0.64, P=0.91). There were no cases of chronic pain and infection among the three groups. Conclusion The three methods of closing direct hernia defect in laparoscopic transabdominalpreperitoneal prosthesis are clinically effective and safe. To choose the way of closing direct hernia defect should make individualized plan according to the speci?c conditions of patients and operators.
