Abstract:

Objective

To explore the clinical efficacy of open preperitoneal tension-free herniorrhaphy and laparoscopic transabdominal preperitoneal herniorrhaphy in elderly patients.

Methods

A total of 233 patients with inguinal hernia who underwent surgical treatment from January 2015 to November 2017 were selected.According to different surgical methods，they were divided into the open surgery group（n=117 cases） and the laparoscopic surgery group （n=116 cases）.The statistical software SPSS21.0 was used for data analysis.Measurement data such as various perioperative indexes were expressed as （±s），and independent samples t test was used； counting data such as postoperative complications were analyzed by chisquare test； univariate and multivariate analyses were performed by Logistics regression analysis.A P value less than 0.05 was considered statistically significant.

Results

The operation time，anesthesia time，postoperative exhaust time，postoperative defecation time and hospitalization cost of the patients in the open surgery group were significantly shorter or lower than those of the patients in the laparoscopic surgery group （P＜0.05）.The incidences of postoperative complications such as nausea and vomiting，delirium，ileus and intestinal obstruction in the open surgery group were significantly lower than those in the laparoscopic surgery group（P＜0.05）.Through univariate analysis，it was found that the operation time ≥ 100 min and the laparoscopic surgical method were influencing factors for the occurrence of long-term postoperative intestinal obstruction.Multivariate analysis showed that the laparoscopic surgical method was not an independent risk factor （P＜0.05）.

Conclusion

Open preperitoneal tension-free herniorrhaphy is more suitable for elderly patients.It has a low incidence of both short-term and long-term postoperative complications.The repair effect is equivalent to that of laparoscopic surgery.It is economical，easy to master，and suitable for promotion in primary medical institutions.

Key words: Senile Inguinal Hernia, Laparoscopic Transabdominal Preperitoneal Hernia Repair, Open Preperitoneal Tension-free Hernioplasty, Postoperative Intestinal Obstruction