Clinical study of laparoscopic high ligation of hernia sac combined with IPOM and local anesthesia Lichtenstein repair in the treatment of male patients with inguinal hernia after radical cystectomy
- VernacularTitle:腹腔镜疝囊高位结扎联合IPOM与局麻李金斯坦修补术治疗男性全膀胱切除术后腹股沟疝
- Author:
Fangxin WAN
1
;
Bin LIU
;
Haocheng ZHANG
;
Changwen ZHANG
;
Baoyu LI
Author Information
- Publication Type:Journal Article
- Keywords: cystectomy; hernia,inguinal; laparoscopy; intraperitoneal onlay mesh; Lichtenstein repair; high ligation of the hernia sac
- From: Tianjin Medical Journal 2025;53(10):1033-1036
- CountryChina
- Language:Chinese
- Abstract: Objective To compare the clinical efficacy of laparoscopic high ligation of the hernia sac combined with intraperitoneal onlay mesh(IPOM)and local anesthesia Lichtenstein repair for the treatment of inguinal hernia after total cystectomy in male patients.Methods A total of 59 male patients who underwent total cystectomy were included in this study and randomly divided into two groups:the laparoscopic high ligation of the hernia sac combined with IPOM group(IPOM group,30 cases)and the local anesthesia Lichtenstein repair group(local anesthesia group,29 cases).The patient age,surgical time,postoperative ambulation time,visual analogue scale score for pain on the 1st to 3rd days and 3 months after operation,time to first mobilization post-operation,pain scores on postoperative day 1,2 and 3,pain scores at 3 months post-operation were observed and compared between the two groups.Data of intraoperative blood loss,hospital stay,time to return to daily activities,total surgery costs,recurrence rates at 1 year after operation and complications were also observed and compared in two groups of patients.The results were analyzed to determine the optimal surgical method.Results The IPOM group demonstrated better outcomes in terms of surgical time,time to first mobilization,pain scores on postoperative days 1,2 and 3,pain scores at 3 months,intraoperative blood loss,hospital stay and time to return to daily activities compared to those of the local anesthesia group(P＜0.01).However,the total cost of the operation was higher in the IPOM group than those of the local anesthesia group(P＜0.01).There were no significant differences in postoperative complications between the two groups(P＞0.05).The recurrence rate of the IPOM group one year after surgery was better than that of the local anesthesia group(P＜0.05).Conclusion Laparoscopic IPOM with high ligation of the hernia sac is superior to the traditional Lichtenstein repair in reducing postoperative pain and recurrence rates.This surgical method should be the first choice when economic conditions permit.
