Evaluation of the clinical effect of tension-free hernia repair for recurrent inguinal hernia
无张力疝修补术治疗腹股沟复发疝临床效果评价

摘要

目的 评价无张力疝修补术治疗腹股沟复发疝临床效果。方法 回顾性分析本院2021年6月-2024年6月腹股沟复发疝行无张力疝修补术治疗的患者60例。结合患者的手术形式分组，其中5例行疝环充填式无张力疝修补术视为A组；10例行Lichtenstein手术（Lichtenstein Tension-Free Hernioplasty）视为B组，45例行腹膜前间隙修补术视为C组。对比手术时间；统计抗生素使用情况；采取术后视觉模拟疼痛量表（VAS，visual analogue scale）评估患者疼痛指数；结合并发症处理与随访情况分析预后效果。结果 手术时间：最短手术用时41min；最长手术用时91min。平均手术时间为（73.25±11.26）min。抗生素使用情况：C组术中常规使用抗生素一次，三组术后抗生素使用时间均低于48h。下床活动时间：平均术后下床活动时间为（8.23±1.24）h。VAS评估；术后1d，VAS评估患者疼痛平均指数为（3.95±1.09）分，术后3d，VAS评估患者均为轻度疼痛平均指数为（2.41±0.75）分。术后并发症情况：其中1例患者出现阴囊血肿、2例出现腹股沟疼痛、3例患者出现尿潴留。总并发症占比为6/60,10%。出院时间以及随访情况：患者术后出院时间为3-9d，平均为（5.41±1.36）d。60例患者均接受随访，36个月内患者无复发（P<0.05）。结论 无张力疝修补术治疗腹股沟复发疝安全性高，无抗生素依赖，术后可早期下床活动，镇痛后患者疼痛指数可明显降低，术后并发症比率偏低，复发率低，治疗效果整体较为理想。

Abstract

Objective To evaluate the clinical effect of tension-free hernia repair in the treatment of recurrent inguinal hernia.
Methods A retrospective analysis was conducted on 60 patients who underwent tension-free hernia repair surgery for recurrent inguinal hernia in our hospital from June 2023 to June 2024. Based on the surgical form of the patients, 5 cases of tension-free hernia repair with hernia ring filling were classified as Group A; 10 cases of Lichtenstein Tension Free Hernioplasty were considered as Group B, and 45 cases of retroperitoneal space repair were considered as Group C. Compare the surgical time; Statistics on the use of antibiotics; Adopting postoperative visual analogue scale (VAS) to evaluate the patient's pain index; Analyze the prognosis based on the management of complications and follow-up results.
Results Surgery time: The shortest surgery time was 41 minutes; The longest surgery took 91 minutes. The average surgical time was (73.25±11.26) minutes. Antibiotic use: Group C routinely used antibiotics once during surgery, and the postoperative antibiotic use time in all three groups was less than 48 hours. Off bed activity time: The average postoperative off bed activity time is (8.23±1.24) hours. VAS assessment; On postoperative day 1, the average pain index of patients evaluated by VAS was (3.95±1.09) points, and on postoperative day 3, the average pain index of patients evaluated by VAS was (2.41±0.75) points. Postoperative complications: 1 patient had scrotal hematoma, 2 patients had pain in the groin, and 3 patients had urinary retention. The proportion of total complications is 6/60,10%. Discharge time and follow-up status: The patient's postoperative discharge time was 3-9 days, with an average of (5.41±1.36) days. All 60 patients were followed up and there was no recurrence within 36 months (P<0.05).
Conclusion   Tension free hernia repair is a safe and antibiotic free treatment for recurrent inguinal hernia. It allows for early mobilization after surgery, significantly reduces pain index after analgesia, has a low incidence of postoperative complications, and a low recurrence rate. Overall, the treatment effect is ideal.