Effects of laparoscopic transabdominal preperitoneal repair and Lichtenstein surgery on post-operative early pain and mobility in patients with inguinal hernia
10.3760/cma.j.cn115610-20241015-00451
- VernacularTitle:腹腔镜经腹腹膜前修补术与Lichtenstein手术对腹股沟疝患者术后早期疼痛和行动力的影响
- Author:
Cong TONG
1
;
Xi CHEN
1
;
Zheqi ZHOU
1
;
Hui WANG
1
;
Xiaolong ZHANG
1
;
Xu ZHAO
1
;
Likun YAN
1
Author Information
1. 陕西省人民医院普通外科一科，西安 710068
- Publication Type:Journal Article
- Keywords:
Inguinal hernia;
Transabdominal preperitoneal repair;
Lichtenstein surgery;
Capacity for action;
Pain;
Efficacy;
Surgery
- From:
Chinese Journal of Digestive Surgery
2024;23(12):1530-1537
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of laparoscopic transabdominal preperitoneal repair (TAPP) and Lichtenstein surgery on postoperative early pain and mobility in patients with inguinal hernia.Methods:The retrospective cohort study was conducted. The clinical data of 184 pati-ents with unilateral inguinal hernia who were admitted to Shaanxi Provincial People's Hospital from June 2021 to December 2022 were collected. There were 152 males and 32 females, aged (64±8)years. Of the 184 patients, 92 cases undergoing TAPP were divided into the TAPP group, and 92 cases under-going Lichtenstein surgery were divided into the Lichtenstein group. Observation indicators: (1) surgical situations; (2) postoperative pain; (3) postoperative mobility. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Paired sample t test was used for comparison within group before and after surgery. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Results:(1) Surgical situations. Total duration of hospital stay, duration of postoperative hospital stay, expense of hospitalization were 1.70(1.00,2.00)days, 1.00(1.00,1.00)days, 14 808(14 385,15 292)yuan in the TAPP group, versus 2.12(2.00,3.00)days, 1.42(1.00,2.00)days, 10 590(9802,11 362)yuan in the Lichtenstein group, showing significant differences in the above indicators between the two groups ( Z=-3.23, -4.07, -11.72, P<0.05). (2) Postoperative pain. Score of verbal rating scale (VRS) were 1.36±0.75 and 3.22±0.66 before surgery and at 20-22 hours after surgery in the TAPP group, versus 1.34±0.80 and 3.42±0.80 in the Lichtenstein group, showing significant differences within the two groups ( t=-29.15, -31.46, P<0.05). (3) Postoperative mobility. The time from getting up to standing bedside of patients before surgery and at 20-22 hours after surgery were (5.47±1.08)seconds and (7.94±2.23)seconds in the TAPP group, versus (5.87±1.13)seconds and (11.59±1.88)seconds in the Lichtenstein group, showing a significant difference at 20-22 hours after surgery between the two groups and significant differences within the two groups ( t=-11.99, -15.64, -27.26, P<0.05). The time for hip flexion 90° of patients before surgery and at 20-22 hours after surgery were (0.74±0.32)seconds and (1.23±0.54)seconds in the TAPP group, versus (0.81±0.19)seconds and (1.97±0.69)seconds in the Lichtenstein group, showing a significant difference at 20-22 hours after surgery between the two groups and significant differences within the two groups ( t=-8.11, -16.53, -17.81, P<0.05). The time for walking 10 meters of patients before surgery and at 20-22 hours after surgery were (10.30±1.53)seconds and (12.80±1.67)seconds in the TAPP group, versus (10.38±1.35)seconds and (18.35±1.69)seconds in the Lichtenstein group, showing a significant difference at 20-22 hours after surgery between the two groups and significant differences within the two groups ( t=-22.44, -33.66, -32.46, P<0.05). The time for walking 20 meters of patients before surgery and at 20-22 hours after surgery were (17.87±2.89)seconds and (24.16±2.54)seconds in the TAPP group, versus (18.02±2.82)seconds and (32.64±2.56)seconds in the Lichtenstein group, showing a significant difference at 20-22 hours after surgery between the two groups and significant differences within the two groups ( t=-22.55, -38.75, -34.59, P<0.05). Conclusion:Compared to Lichtenstein surgery, patients with TAPP experience faster recovery of mobility, earlier discharge, and higher expense of hospitalization.
