Effect of Laparoscopic <i>Versus</i> Open Tension-Free Hernioplasty on Early Postoperative Pain for Patients with Inguinal Hernia_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANGHua , WANGJun-wei , PENGXue-feng ,  JINXin-fu

Department of General Surgery, The 4th People's Hospital of Zigong City, Zigong 643000, Sichuan Province, China;

Corresponding author：

JINXin-fu, Email: 19393148@qq.com

Keywords：

Tension-free hernioplasty; Laparoscope; Pain; Inguinal hernia

DOI：

10.7507/1007-9424.20160353

Video：

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Objective To compare degree and characteristics of early postoperative pain for patients with inguinal hernia underwent laparoscopic versus open tension-free hernioplasty. Methods The clinical data of 120 patients who underwent tension-free hernioplasty from July 2013 to June 2015 were analyzed. All of the patients were divided into open tension-free hernioplasty group (open group, n=60) and laparoscopic tension-free hernioplasty group (laparoscope group, n=60). Visual analogue scale (VAS) score was evaluated at different time point. Results ① Within 12 h after operation, the comparison of total VAS score between the laparoscope group and the open group had no significant difference (F=1.674, P=0.198), the difference of VAS score in these two groups was significantly different at each time point (F=21.186, P=0.000), and the variation tendency was influenced by grouping factors (F=87.038, P=0.000). ② Within 7 d after opera-tion, the differences of comparison of total VAS score between the laparoscope group and the open group and at each time point were statistically significant (F=46.358, P=0.000; F=576.387, P=0.000) and had a downtrend, further more the variation tendency was influenced by grouping factors (F=19.454, P=0.000). ③ The composition ratios of pain site and characteristics had significant differences between these two groups within 7d after operation (χ²=10.108, P=0.001; χ²=7.144, P=0.028), the dosage of analgesic drugs between two groups had no significant difference (t=0.872, P=0.386). Conclusion As a representative of minimally invasive surgery, laparoscopic technology has certain advantages in reducing postoperative pain for patients with inguinal hernia, but minimally invasive technique does not mean to painless. Further improvement is needed by hernia surgery.

Citation： YANGHua, WANGJun-wei, PENGXue-feng, JINXin-fu. Effect of Laparoscopic Versus Open Tension-Free Hernioplasty on Early Postoperative Pain for Patients with Inguinal Hernia. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(11): 1384-1388. doi: 10.7507/1007-9424.20160353 Copy

1.	陈双. 从解剖入手做好腹股沟疝规范手术. 中国实用外科杂志, 2014, 34(5):384-385.
2.	方积乾. 生存质量测定方法及应用. 北京:北京医科大学出版社, 2000:49-53.
3.	Dahlstrand U, Sandblom G, Nordin P, et al. Chronic pain after femoral hernia repair:a cross-sectional study. Ann Surg, 2011, 254 (6):1017-1021.
4.	Dahlstrand U, Sandblom G, Ljungdahl M, et al. TEP under general anesthesia is superior to Lichtenstein under local anesthesia in terms of pain 6 weeks after surgery:results from a randomized clinical trial. Surg Endosc, 2013, 27(10):3632-3638.
5.	Kleidari B, Mahmoudieh M, Yaribakht M, et al. Mesh fixation in TAPP laparoscopic hernia repair:introduction of a new method in a prospective randomized trial. Surg Endosc, 2014, 28(2):531-536.
6.	中华医学会外科学分会疝和腹壁外科学组. 成人腹股沟疝诊疗指南. 中国实用外科杂志, 2012, 32(10):833-835.
7.	中华医学会外科分会腹腔镜与内镜外科学组, 中华医学会外科分会疝与腹壁外科学组, 大中华腔镜疝外科学院. 腹股沟疝腹腔镜手术规范化操作指南. 中国实用外科杂志, 2013, 33(7):566-570.
8.	郝双林, 田宝斌, 王玲, 等. VAS测痛法的临床初步评估. 中国医学科学院学报, 1994, 15(6):397-399.
9.	王会民, 路桃影, 吴大嵘, 等. 疼痛测量工具的应答模式评析. 循证医学理论与方法, 2015, 15(2):102-107.
10.	Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Associa-tion for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl, 1986, 3:S1-S226.
11.	Poobalan AS, Bruce J, Smith WC, et al. A review of chronic pain after inguinal herniorrhaphy. Clin J Pain, 19(1):48-54.
12.	Callesen T, Bech K, Kehlet H. Prospective study of chronic pain after groin hernia repair. Br J Surg, 1999, 86(12):1528-1531.
13.	赵渝, 王刚. 腹股沟疝修补术后慢性疼痛的原因及治疗. 中国实用外科杂志, 2006, 26(11):826-828.
14.	陈鑫, 李健文. 从循证医学角度谈腹腔镜腹股沟疝修补术20年进展. 中国实用外科杂志, 2014, 34(5):391-395.
15.	黄耿文, 肖广发, 李宜雄. 高龄患者对侧隐匿性腹股沟疝的外科治疗. 中华疝与腹壁外科杂志:电子版, 2014, 8(1):19-20.
16.	Köninger J, Redecke J, Butters M. Chronic pain after hernia repair:a randomized trial comparing Shouldice, Lichtenstein and TAPP. Langenbecks Arch Surg, 2004, 389(5):361-365.
17.	何文, 杨柳, 黄耿文, 等. 腹腔镜下腹股沟疝修补术后疼痛调查. 中华疝与腹壁外科杂志:电子版, 2015, 9(5):424-426.
18.	朱雷明, 姜卫东, 朱建斌, 等. 腹腔镜完全腹膜外腹股沟疝修补术中补片钉合固定与医用胶固定的对照研究. 中华疝和腹壁外科杂志:电子版, 2012, 6(2):718-723.
19.	吴强, 于游, 王灿. 无张力腹股沟疝修补术后慢性疼痛原因分析及治疗. 中国普外基础与临床杂志, 2009, 16(2):95-97.

1. 陈双. 从解剖入手做好腹股沟疝规范手术. 中国实用外科杂志, 2014, 34(5):384-385.
2. 方积乾. 生存质量测定方法及应用. 北京:北京医科大学出版社, 2000:49-53.
3. Dahlstrand U, Sandblom G, Nordin P, et al. Chronic pain after femoral hernia repair:a cross-sectional study. Ann Surg, 2011, 254 (6):1017-1021.
4. Dahlstrand U, Sandblom G, Ljungdahl M, et al. TEP under general anesthesia is superior to Lichtenstein under local anesthesia in terms of pain 6 weeks after surgery:results from a randomized clinical trial. Surg Endosc, 2013, 27(10):3632-3638.
5. Kleidari B, Mahmoudieh M, Yaribakht M, et al. Mesh fixation in TAPP laparoscopic hernia repair:introduction of a new method in a prospective randomized trial. Surg Endosc, 2014, 28(2):531-536.
6. 中华医学会外科学分会疝和腹壁外科学组. 成人腹股沟疝诊疗指南. 中国实用外科杂志, 2012, 32(10):833-835.
7. 中华医学会外科分会腹腔镜与内镜外科学组, 中华医学会外科分会疝与腹壁外科学组, 大中华腔镜疝外科学院. 腹股沟疝腹腔镜手术规范化操作指南. 中国实用外科杂志, 2013, 33(7):566-570.
8. 郝双林, 田宝斌, 王玲, 等. VAS测痛法的临床初步评估. 中国医学科学院学报, 1994, 15(6):397-399.
9. 王会民, 路桃影, 吴大嵘, 等. 疼痛测量工具的应答模式评析. 循证医学理论与方法, 2015, 15(2):102-107.
10. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Associa-tion for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl, 1986, 3:S1-S226.
11. Poobalan AS, Bruce J, Smith WC, et al. A review of chronic pain after inguinal herniorrhaphy. Clin J Pain, 19(1):48-54.
12. Callesen T, Bech K, Kehlet H. Prospective study of chronic pain after groin hernia repair. Br J Surg, 1999, 86(12):1528-1531.
13. 赵渝, 王刚. 腹股沟疝修补术后慢性疼痛的原因及治疗. 中国实用外科杂志, 2006, 26(11):826-828.
14. 陈鑫, 李健文. 从循证医学角度谈腹腔镜腹股沟疝修补术20年进展. 中国实用外科杂志, 2014, 34(5):391-395.
15. 黄耿文, 肖广发, 李宜雄. 高龄患者对侧隐匿性腹股沟疝的外科治疗. 中华疝与腹壁外科杂志:电子版, 2014, 8(1):19-20.
16. Köninger J, Redecke J, Butters M. Chronic pain after hernia repair:a randomized trial comparing Shouldice, Lichtenstein and TAPP. Langenbecks Arch Surg, 2004, 389(5):361-365.
17. 何文, 杨柳, 黄耿文, 等. 腹腔镜下腹股沟疝修补术后疼痛调查. 中华疝与腹壁外科杂志:电子版, 2015, 9(5):424-426.
18. 朱雷明, 姜卫东, 朱建斌, 等. 腹腔镜完全腹膜外腹股沟疝修补术中补片钉合固定与医用胶固定的对照研究. 中华疝和腹壁外科杂志:电子版, 2012, 6(2):718-723.
19. 吴强, 于游, 王灿. 无张力腹股沟疝修补术后慢性疼痛原因分析及治疗. 中国普外基础与临床杂志, 2009, 16(2):95-97.

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Effect of Laparoscopic Versus Open Tension-Free Hernioplasty on Early Postoperative Pain for Patients with Inguinal Hernia

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