Effect of Laparoscopic Ventral and Incisional Hernia Repair in the Treat-ment of Senile Inguinal Hernia with Hernia Ring Adhesion

ZHONG Ren; WU Cen; GAO Zhihui; CAI Bing

doi:10.3969/j.issn.1002-3429.2023.09.013

Abstract：Objective To investigate the effect of laparoscopic ventral and incisional hernia repair(LVHR)in the treatment of senile inguinal hernia with hernia ring adhesion.Methods A total of 100 elderly patients with inguinal hernia and hernia ring adhesion treated from January 2020 to August 2022 were selected as the research subjects and divided into con-trol group and observation group according to different surgical methods,with 50 cases in each group.The control group un-derwent open surgery,and the observation group underwent LVHR.The intraoperative conditions,complications,postopera-tive recovery indexes,surgical incision satisfaction,incision scar rate,recurrence rate,stress indexes before and after surgery[serum cortisol(Cor),aldosterone(ALD),noadrenaline(NE)],intestinal mucosal barrier function[plasma glutamine(Gln),diamine oxidase(DAO)and urinary intestinal fatty acid binding protein(IFABP)]were compared between the two groups.Results The intraoperative blood loss and incision length of observation group were lower or shorter than those of control group(P＜0.01).At 1 d after operation,serum ALD,NE,Cor,plasma DAO and urinary IFABP levels in observa-tion group were lower than those in control group,and plasma Gln levels were higher than those in control group(P＜0.05).The time of anal exhaust,length of hospital stay and time of off-bed activity in the observation group were shorter than those in the control group,and the visual analogue scale scores at 1 d after operation were lower in the observation group than in the control group(P＜0.01).The total complication rate of the observation group was lower than that of the control group(P＜0.01).At 3-month follow-up after the operation,the incision satisfaction of the observation group was higher than that of the control group(P＜0.01),and there was no significant difference in the scar rate and recurrence rate of the incision between the two groups(P＞0.05).Conclusion LVHR is effective in the treatment of elderly patients with inguinal hernia and her-nia ring adhesion,which can reduce body stress response,improve intestinal mucosal barrier function,and effectively promote postoperative recovery of patients.