Abstract：【Objective】 To compare the clinical outcomes of mesh fixation versus non-fixation in laparoscopic transabdominal preperitoneal(TAPP) inguinal hernia repair.【Methods】 A total of 88 patients with inguinal hernia treated at Xinye County Health Vocational Secondary School Affiliated Hospital from January 2021 to October 2024 were included in this study. All patients underwent laparoscopic TAPP inguinal hernia repair and were randomly assigned into two groups using a random number table:the observation group(non-fixation of mesh, n=44) and the control group(mesh fixation, n=44). The two groups were compared in terms of mesh placement time, peritoneal suturing time, blood loss, operative time, length of hospital stays, Visual Analog Scale(VAS) scores, and the incidence of postoperative complications.【Results】 The bleeding volume of the observation group was lower than that of the control group, and the operation time and hospitalization time were shorter than those of the control group, with statistical significance(P<0.05); There was no statistically significant difference(P>0.05) in the placement time and peritoneal suturing time between the two networks. The VAS scores of the observation group were lower than those of the control group on the 2nd day, 1st month, and 3rd month after surgery, and the difference was statistically significant(P<0.05). The total incidence of complications within 3 months after surgery in the observation group and control group was 22.73%(10/44) and 18.18%(8/44), respectively. There was no statistically significant difference in the incidence of postoperative complications between the two groups(χ2=0.279,P>0.05).【Conclusion】 Non fixed mesh laparoscopic TAPP treatment for inguinal hernia has a good effect, which can effectively shorten the operation time and hospitalization time, as well as reduce postoperative pain. It has high safety and is worthy of clinical reference.
[1] 杨寅熙,吴一峰,吴铁. TEP与TAPP术治疗腹股沟疝临床疗效比较[J].中国现代手术学杂志,2018,22(4):241-243. [2] 韩华,李洲,卢通. 不同TAPP术治疗巨大腹股沟疝的疗效及对应激反应术后并发症的影响[J].河北医学,2024,30(6):964. [3] 王伟,赵宇斌. TAPP与传统腹股沟疝无张力修补术对成人腹股沟疝手术应激及疼痛影响的对比研究[J].医学临床研究,2021,38(4):504-507. [4] 中华医学会外科学分会疝与腹壁外科学组,中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J].中华外科杂志,2018,56(7):495-498. [5] 田国标,陈晓波,朱江,等. Lichtenstein、TEP及TAPP对成人腹股沟疝患者术后VAS评分及CRP、IL-6和TNF-α水平的影响[J].分子诊断与治疗杂志,2023,15(12):2194-2197. [6] 何苗,曾心雨,刘杰锋. 腹腔镜腹膜前疝修补和全腹膜外疝修补术治疗腹股沟疝的优劣比较[J].中国现代手术学杂志,2020,24(1):71-75. [7] 王祥东,付笑,刘松. 腹腔镜经腹腹膜前疝修补术对成人复发性腹股沟疝的近远期疗效分析[J].河北医学,2022,28(9):1534. [8] 邹永红,田瑞雪. 三种成人腹股沟疝术式的疗效及手术对术区术后慢性疼痛影响的比较研究[J].医学临床研究,2021,38(9):1331-1333. [9] 张健,张成新,郭卫华. 免固定补片TAPP术对腹股沟疝患者慢性疼痛和生活质量的影响[J].武警后勤学院学报(医学版),2020,29(9):58-61. [10] 韩华,李洲,卢通. 不同TAPP术治疗巨大腹股沟疝的疗效及对应激反应术后并发症的影响[J].河北医学,2024,30(6):964. [11] 房鑫,李文浩,王静,等. 不同平台入路单孔腹腔镜经腹腹膜前腹股沟疝修补术的对照研究[J].腹腔镜外科杂志,2024,29(11):853-857. [12] ALI R F, ELHUSSAINY R M, AOUF A M, et al. Outcomes of mesh fixation versus non fixation in laparoscopic transabdominal preperitoneal inguinal hernia repair:a randomized clinical study[J].J Pak Med Assoc,2023,73(Suppl 4):S8-S12. [13] AZEVEDO M A, OLIVEIRA G B T, MALHEIROS C A, et al.Are there differences in chronic pain after laparoscopic inguinal hernia repair using the transabdominal technique comparing with fixation of the mesh with staples, with glue or without fixation? A clinical randomized, double-blind trial[J].Arq Bras Cir Dig,2022,35:e1670. [14] 安玉怀. 腹腔镜经腹腹膜前修补术中不同疝补片固定方法对老年腹股沟疝患者的影响对比[J].中国药物与临床,2020,20(22):3765-3767.
2025, Vol. 42 
