Application value of ambulatory surgery mode in inguinal hernia repair / 中华消化外科杂志

ABSTRACT

Objective:To investigate the application value of ambulatory surgery mode in inguinal hernia repair.Methods:The retrospective and descriptive study was conducted. The clinical data of 416 patients with inguinal hernia who were admitted to the Meishan People′s Hospital, West China Hospital of Sichuan University from January 2020 to January 2022 were collected. There were 374 males and 42 females, aged 52(range, 25-70)years. All patients underwent inguinal hernia repair with the ambulatory surgery mode. Observation indicators: (1) surgical situations; (2) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. Of the 416 patients, 258 patients underwent laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) under general anesthesia and 158 patients underwent open inguinal hernia repair under local anesthesia (98 cases of Lichtenstein repair and 60 cases of preperitoneal repair). The intraoperative measured diameter of hernia ring defect and operation time of the 416 patients were 1.9 (range, 0.9-3.2)cm and 52 (range, 35-80)minutes. The duration of hospital stay of the 416 patients <48 hours, including 395 cases with the duration of hospital stay <24 hours. There were 21 patients with delayed discharge including 12 cases as post-operative pain, 8 cases as adverse reactions to general anesthesia, and 1 case as postoperative seroma. (2) Follow-up. All 416 patients were followed up for 12 months after surgery. During the follow-up period, there was no serious complication such as recurrent inguinal hernia, wound infection, intestinal fistula or obstruction. At 1 month after surgery, ultrasound examination of the inguinal area did not reveal any serum swelling or seroma. The postoperative visual analogue scale of pain in patients undergoing laparoscopic TAPP was 2.70±0.10 at postoperative 3 days and 0 at postoperative 12 months. The above indicator in patients undergoing Lichtenstein repair and pre-peritoneal repair was from 3.20±0.20 and 3.00±0.10 at postoperative 3 days to 0 and 0 at post-operative 12 months, respectively. All patients did not experience chronic pain for more than 3 months. All 416 patients conducted satisfaction surveys over the phone, and all of them were very satisfied or satisfied, with a satisfaction rate as 100.00%(416/416).Conclusion:Ambulatory surgery mode in inguinal hernia repair is safe and feasible.