Abstract：Objective: To investigate the clinical effect and safety of transabdominal preperitoneal (TAPP), totally exntraperitoneal prosthesis (TEP) and open tension free hernia repair (Rutkow) in the treatment of adult inguinal hernia. Methods: Clinical data of 936 cases (1116 sides) of adult inguinal hernia treated in our hospital from January 2009 to January 2016 were analyzed retrospectively. The patients were divided into TAPP group, TEP group and open group, according to different treatment methods, 152 cases (174 sides), 336 cases (449 sides) and 448 cases (493 sides), respectively. The operation time, the VAS pain score at first day of postoperative, length of stay, postoperative complications of two groups were observed. After 6～40 months (media 21 months) follow up, the recurrence of two groups were observed. Results: Operation time: unilateral hernia: TAPP group > TEP group > open group, the difference was statistically significant (P < 0.05). Bilateral hernia: TAPP and open group > TEP group, the difference was statistically significant (P < 0.05), there was no significant difference between the TAPP group and the open group (P > 0.05). Length of stay: the open group was significantly longer than the TAPP group and TEP group (P < 0.05), while there was no significant difference between the TAPP group and the TEP group (P > 0.05). Incidence of complications: open group > TAPP group and TEP group, the difference was statistically significant (P < 0.05), there was no significant difference between TAPP group and TEP group (P > 0.05). The recurrence rate of open group was 0.89%, the recurrence rate of TAPP group was 0.66%, the recurrence rate of TEP group was 0.60%, and there was no significant difference in recurrence rate between the three groups (P > 0.05). The postoperative urinary retention, chronic pain or numbness in the open group were higher than those in the TAPP group and TEP group (P < 0.05). Conclusion: TAPP and TEP in the treatment of adult inguinal hernia is satisfactory, especially in the treatment of bilateral inguinal hernia, can significantly reduce the degree of postoperative pain, shorten the length of stay, reduce postoperative urinary retention, chronic pain or numbness, and other complications
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2017, Vol. 23 
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