Abstract:【Objective】 To compare the efficacy of hernia sac transection and complete hernia sac exfoliation for laparoscopic transabdominal preperitoneal (TAPP) hernia repair in patients with a maximum oblique inguinal hernia sac diameter of ≥ 5 cm. 【Methods】 A total of 90 male patients with oblique inguinal hernia admitted to our hospital from January 2020 to January 2023 were selected in this study. All patients received the TAPP laparoscopic hernia repair. According to different treatment methods of hernia sac, patients were divided into a transection group (in which the hernia sac was transected intraoperatively) and a complete exfoliation group (in which the hernia sac was completely dissected intraoperatively), with 45 cases in each group. The clinical indicators, pain levels [Visual Analogue Scale (VAS) scores], laboratory parameters [Total Antioxidant Capacity (TAC), Cortisol (Cor), Malondialdehyde (MDA), Tumor Necrosis Factor α(TNF-α), and Interleukin-6 (IL-6)], and the incidence of complications between the two groups were compared and analyzed. 【Results】 The operative time and hernia sac management time in the transection group were significantly shorter than those in the complete exfoliation group; and the intraoperative blood loss and incidence of inguinal seroma were significantly lower than those in the complete exfoliation group (all P<0.05). The VAS scores at postoperative day 1 and day 3 in both groups were significantly lower than those at 12 hours postoperatively, and the VAS score at postoperative day 3 was significantly lower than that at postoperative day 1. Moreover, the VAS scores in the transection group at 1 day and 3 days postoperatively were significantly lower than those in the complete exfoliation group (all P<0.05). At 3 days postoperatively, the serum levels of TAC, Cor, MDA, TNF-α, and IL-6 in the transection group were significantly lower than those in the complete exfoliation group (P<0.05). The total incidence of postoperative complications in the transection group was significantly lower than that in the complete exfoliation group (P<0.05). 【Conclusion】 For the treatment of patients with oblique inguinal hernia with the diameter of the hernia sac > 5cm, both laparoscopic transection and complete exfoliation of the hernia sac are effective approaches during TAPP surgery. Compared to the complete exfoliation of the hernia sac, the transection of the hernia sac can shorten the operation time and the hernia sac handling time, reduce the amount of intraoperative blood loss and alleviates postoperative pain; furthermore, it exerts a lesser impact on the levels of oxidative stress and inflammatory response, offering the advantages of fewer complications and higher safety.
吴红杰. 横断疝囊及完全剥离疝囊在腹股沟斜疝腹腔镜手术中的效果比较[J]. 医学临床研究, 2026, 43(4): 614-617.
WU Hongjie. Comparison of Efficacy of Hernia Sac Transection versus Complete Exfoliation in Laparoscopic Surgery for Oblique Inguinal Hernia. JOURNAL OF CLINICAL RESEARCH, 2026, 43(4): 614-617.