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Objective: To investigate the effects of laparoscopic preperitoneal hernia repair (TAPP) and Lichtenstein hernia repair for inguinal hernia on serum testosterone concentration and matrix metalloproteinase-2 (MMP-2). Methods: From January 2017 to January 2021, 80 patients with inguinal hernia were selected, and they were divided into TAPP group (n=44) and Lichtenstein group (n=36) by random number table, and the two groups of surgical indicators and surgery were recorded. For post-operative complications and recurrence rates, serum testosterone and MMP-2 levels were measured before and 1 month after surgery. Results: The amount of intraoperative blood loss and postoperative anal exhaust time in TAPP group were lower than those in Lichtenstein group (P<0.05), and there was no difference in the operative time between the two groups (P>0.05). The postoperative hospital stay in TAPP group was shorter than that in Lichtenstein group, and the hospitalization cost was higher than that in Lichtenstein group (P<0.05). There was no difference in postoperative recurrence rate between the two groups (P>0.05). The incidence of scrotal edema in TAPP group was lower than that in Lichtenstein group (P<0.05), but there was no difference in other complications among groups (P>0.05). There was no change in serum testosterone in both groups before and after operation (P<0.05). The level of MMP-2 in both groups was decreased after surgery (P<0.05), but there was no difference between groups (P>0.05). Conclusion: Both surgical methods have no damage to the testicular function of patients with inguinal hernia, and both can effectively reduce the serum MMP-2 level, prevent the recurrence of the inguinal hernia, and are safe and effective. In contrast, the laparoscopic ATPP has less trauma and the operation The recovery is faster, but the operation is more difficult and costly. The two surgical methods have their own advantages and disadvantages. The surgical method needs to be selected according to the actual situation of the patient. [ABSTRACT FROM AUTHOR]

To compare the curative effect of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and Lichtenstein's tension-free hernia repair of two types of surgery in the treatment of elderly patients with inguinal hernia. Methods: Clinical data of 118 elderly patients（≥ 60 years) with inguinal hernia in department of Thyroid and Hernia Surgery in Yueyang Hospital of integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from August 2018 to July 2020were retrospectively analyzed. According to different surgical methods, 68 patients received TAPP as the TAPP group, and 50 patients received Lichtenstein's tension-free hernia repair as the Lichtenstein group. The operative time, intraoperative blood loss, post operative visual analog scale (VAS) score, exhaust time, hospital stay and postoperative short-term and long-term complication rate were compared between the two groups. There was no significant difference in operation time between the two groups (P>0.05). The intraoperative blood loss, exhaust time and hospital stay in the TAPP group were significantly lower than those in the Lichtenstein group (P<0.05).The VAS scores of incision at different time points after operation in TAPP group were significantly lower than those in Lichtenstein group (P<0.05). The incidence of short-term complications in the TAPP group was significantly lower than that in the Lichtenstein group(P<0.05). There was no significant difference in the incidence of long-term complications between the two groups (P>0.05). Compared with Lichtenstein's tension-free hernia repair, TAPP is a safe and effective surgical method for the treatment of elderly patients with inguinal hernia, which can reduce postoperative pain, faster recovery and lower complication rate, and which is worthy of promotion and application. [ABSTRACT FROM AUTHOR]

To explore the value of transverse abdominal plane block and intravenous analgesia in hernia surgery. From January 2019 to December 2020, 120 patients undergoing inguinal hernia surgery in our hospital were selected as research subjects. According to the difference of anesthesia methods, they were divided into two groups. The control group was given intravenous analgesia, while the observation group was given transverse abdominal plane block. The intraoperative doses of propofol, ephedrine and fentanyl in the two groups of patients, as well as the VAS score and the number of fentanyl supplements at different times after the operation were recorded; the incidence of postoperative nausea and vomiting between the two groups was compared, and Compare eating time, intestinal function recovery time, and time to get out of bed. The dosages of propofol, ephedrine and fentanyl in the observation group were significantly less than those in the control group (P<0.05). The VAS scores of 1 h (T0), 5 h (T1), 10 h (T2), 1 d (T3), 2 d (T4) in the observation group were significantly lower than those in the control group (P<0.05). The number of additional fentanyl in the observation group was 4 times per person(P<0.05). The incidence of nausea and vomiting (6.67%), eating time, intestinal function recovery time, and time to get out of bed in the observation group after hernia surgery were significantly lower than those in the control group (P<0.05). Transverse abdominis plane block is significantly better than intravenous analgesia for patients with inguinal hernia after surgery, and it is more helpful to promote postoperative recovery. [ABSTRACT FROM AUTHOR]

Objective: To investigate the hemodynamic changes and anesthetic effects of the application of ultrasound guided lumbar plexus nerve block in indirect inguinal hernia surgery in eldly patients. Methods: 39 patients with indirect inguinal hernia surgery were randomly divided into observation group（19 cases, Group U）and control group（20 cases, Group C）. The observation group was treated with ultrasound guided lumbar plexus block anesthesia, while the control group was treated with combined spinal-epidural anesthesia. Mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SPO2)were compared at the time pre-anethesia (T0), the time after anesthesia [5 mins(T1), 10 mins (T2), 20 mins (T3), 60 mins (T4)] and the time post-operation (T5); to compare the anesthetic effects between two groups; the VAS scores were recorded at 4, 8, 12, 24, 48 hours after anesthesia; to record the cases of postoperative nausea, vomiting, headache and urinary retention. Results: In Group C, the HR at T1, T2, T3 were higher than those in Group U, the difference was statistically significant (P<0.05); in Group C, the MAP at T1, T2, T3 were lower than those in Group U, the difference was statistically significant（P<0.05）; the anesthesia excellent rate of two groups were both 100%; at 8 h and 12 h after anesthesia, the VAS scores of Group C were both higher than those of Group U, the difference was statistically significant（P<0.05）; in Group C, the use of vasopressors was higher than that in Group U, the difference was statistically significant (P<0.05); in Group C, postoperative nausea and vomiting and urinary retention rate was higher than that of GroupU (P<0.05). Conclusions: Ultrasound guided lumbar plexus block anesthesia used in inguinal hernia surgery has reliable effect, stable hemodynamics and fewer complications. [ABSTRACT FROM AUTHOR]