Safety and efficacy of day surgery laparoscopic transabdominal preperitoneal repair in high-altitude areas_West China Medical Journal

Authors：

Lü Meng ,  SU Wei

Department of Hernia Surgery, Qinghai Red Cross Hospital, Xi’ning, Qinghai 810000, P. R. China;

Corresponding?author：

SU Wei, Email: 37124796@qq.com

Keywords：

High-altitude area; day surgery; laparoscopic transabdominal preperitoneal repair

DOI：

10.7507/1002-0179.202512378

Video：

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Objective To evaluate the safety and efficacy of day surgery laparoscopic transabdominal preperitoneal repair (TAPP) in high-altitude areas. Methods The clinical data of TAPP patients admitted to the Department of Hernia Surgery, Qinghai Red Cross Hospital between January 2022 and December 2024 were retrospectively analyzed. The patients were divided into the day surgery group and the inpatient group according to the surgical method. Logistic regression was used to calculate propensity score, incorporating variables such as sex, age, ethnicity, body mass index, hernia side, hernia type, and hernia classification. Matching samples were obtained by nearest neighbor 1∶1 without replacement matching, and hospital stay, total hospitalization costs, and postoperative complications were compared. Results A total of 388 patients were included. Among them, there were 342 males and 46 females; the average age was (48.48±16.08) years. A total of 98 matching samples were obtained. In the matched 98 pairs of samples, compared with the conventional group, the day surgery group had a shorter length of stay [1.0 (1.0, 1.0) d vs. 5.0 (4.0, 7.0) d, P<0.001] and a lower total cost [9 335.6 (8 332.9, 10 709.8) vs. 1 1130.7 (959.9, 12 286.9) yuan, P＜0.001]. There was no statistically significant difference in the incidence of early postoperative pain score, postoperative delayed wound healing / infection, postoperative chronic pain, postoperative seroma, and unplanned return visits between the two groups (P>0.05). Conclusions Day-surgery TAPP repair for inguinal hernia appears safe and effective in a high-altitude region, with the added benefits of reduced hospital stay and lower costs. This approach may be considered for wider clinical implementation.

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2.	Bittner R, Felix EL. History of inguinal hernia repair, laparoendoscopic techniques, implementation in surgical praxis, and future perspectives: considerations of two pioneers. Int J Abdom Wall Hernia Surg, 2021, 4(4): 133-155.
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4.	韓超, 祝學梅, 王瑩, 等. 日間醫療的規范化發展思考. 實用醫學志, 2024, 40(8): 1038-1041.
5.	陳雙, 唐健雄, 周太成, 等. 腹股溝疝診療指南(2024 版). 中國實用外科雜志, 2025, 45(2): 121-127.
6.	呂硯青, 展翔, 段希斌. “集中管理+分散收治”日間手術管理模式經驗分享. 華西醫學, 2024, 39(2): 279-282.
7.	唐健雄, 鄭民華, 陳杰, 等. 腹腔鏡腹股溝疝手術操作指南(2017 版). 中國實用外科雜志, 2017, 37(11): 1238-1242.
8.	Berger D. Evidence-based hernia treatment in adults. Dtsch Arztebl Int, 2016, 113(9): 150-157.
9.	Morales-Conde S. A new classification for seroma after laparoscopic ventral hernia repair. Hernia, 2012, 16(3): 261-267.
10.	Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res, 2011, 46(3): 399-424.
11.	Guillaumes S, Hidalgo NJ, Bachero I, et al. Outpatient inguinal hernia repair in Spain: a population-based study of 1, 163, 039 patients-clinical and socioeconomic factors associated with the choice of day surgery. Updates Surg, 2023, 75(1): 65-75.
12.	Zhong Y, He M, Liu Z, et al. Efficacy of laparoscopic inguinal hernia in day surgery mode and inpatient surgery mode in China: a meta-analysis. Medicine (Baltimore), 2023, 102(8): e32998.
13.	鄧先銳, 鄭磊, 徐通海, 等. 日間手術模式在腹股溝疝修補術中的應用價值. 中華消化外科雜志, 2023, 22(9): 1075-1079.
14.	青海國土經略. 青海省發布《青海省第一次全國地理國情普查公報》. 青海國土經略, 2017(5): 92-93.
15.	張英. 高原環境血紅蛋白變化的若干研究. 高原醫學雜志, 2008(2): 62-64.
16.	于均濤, 丹珠永吉, 徐妮, 等. 海南州貴德縣 1612 名健康成人靜脈血紅細胞、血紅蛋白、血小板計數參考值范圍及影響因素調查. 職業與健康, 2020, 36(11): 1519-1521,1526.
17.	屈振武, 趙永奎, 郭志偉. 基于傾向性評分匹配對比不同年齡分層中 TAPP 治療老年腹股溝疝的臨床效果. 中國老年學雜志, 2025, 45(2): 330-333.
18.	張天昊, 郝志偉, 安杰, 等. 老年腹股溝疝術后并發癥風險列線圖預測模型的建立及驗證. 腹腔鏡外科雜志, 2024, 29(6): 451-456.
19.	Akunov A, Sydykov A, Toktash T, et al. Hemoglobin changes after long-term intermittent work at high altitude. Front Physiol, 2018, 9: 1552.
20.	Treml B, Wallner B, Blank C, et al. The influence of environmental hypoxia on hemostasis-a systematic review. Front Cardiovasc Med, 2022, 9: 813550.
21.	Fan N, Liu C, Ren M. Effect of different high altitudes on vascular endothelial function in healthy people. Medicine (Baltimore), 2020, 99(11): e19292.
22.	De Pablo-Moreno JA, Serrano LJ, Revuelta L, et al. The vascular endothelium and coagulation: homeostasis, disease, and treatment, with a focus on the von willebrand factor and factors VⅢ and Ⅴ. Int J Mol Sci, 2022, 23(15): 8283.
23.	Hillary TM, Vanhoutvin T, Peeters M, et al. A prospective, monocentric case-control study on uncontrolled psoriasis as independent risk factor for a hypercoagulable state. Dermatol Ther (Heidelb), 2024, 14(3): 767-775.
24.	Kamani F, Ghorbani H, Mahmoudabadi FD, et al. Modified Lichtenstein hernioplasty with concomitant tissue repair: a retrospective study on postoperative chronic pain. BMC Surg. 2024, 24(1): 222.
25.	Li J. Patient-reported chronic pain after open inguinal hernia repair with lightweight or heavyweight mesh: a prospective, patient-reported outcomes study. Br J Surg, 2020, 107(13): e657.
26.	Elmessiry MM, Gebaly AA. Laparoscopic versus open mesh repair of bilateral primary inguinal hernia: a three-armed randomized controlled trial. Ann Med Surg (Lond), 2020, 59: 145-150.
27.	寧彩虹, 黃耿文, 林嘉晏, 等. 腹腔鏡經腹腹膜前疝修補日間手術的臨床價值分析. 中國普通外科雜志, 2021, 30(4): 399-405.
28.	李為明, 許青文, 李奕俊, 等. 腹腔鏡腹股溝疝修補術日間手術模式的臨床效益評價. 中華疝和腹壁外科雜志(電子版), 2021, 15(1): 19-21.
29.	Guttadauro A, Maternini M, Lo Bianco G, et al. 15 years experience in proctological day-surgery. Ann Ital Chir, 2018, 89: 324-329.

1. HerniaSurge Group. International guidelines for groin hernia management. Hernia, 2018, 22(1): 1-165.
2. Bittner R, Felix EL. History of inguinal hernia repair, laparoendoscopic techniques, implementation in surgical praxis, and future perspectives: considerations of two pioneers. Int J Abdom Wall Hernia Surg, 2021, 4(4): 133-155.
3. 國際日間手術學會, 中國日間手術合作聯盟. 日間手術發展與實踐. 北京: 人民衛生出版社, 2016.
4. 韓超, 祝學梅, 王瑩, 等. 日間醫療的規范化發展思考. 實用醫學志, 2024, 40(8): 1038-1041.
5. 陳雙, 唐健雄, 周太成, 等. 腹股溝疝診療指南(2024 版). 中國實用外科雜志, 2025, 45(2): 121-127.
6. 呂硯青, 展翔, 段希斌. “集中管理+分散收治”日間手術管理模式經驗分享. 華西醫學, 2024, 39(2): 279-282.
7. 唐健雄, 鄭民華, 陳杰, 等. 腹腔鏡腹股溝疝手術操作指南(2017 版). 中國實用外科雜志, 2017, 37(11): 1238-1242.
8. Berger D. Evidence-based hernia treatment in adults. Dtsch Arztebl Int, 2016, 113(9): 150-157.
9. Morales-Conde S. A new classification for seroma after laparoscopic ventral hernia repair. Hernia, 2012, 16(3): 261-267.
10. Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res, 2011, 46(3): 399-424.
11. Guillaumes S, Hidalgo NJ, Bachero I, et al. Outpatient inguinal hernia repair in Spain: a population-based study of 1, 163, 039 patients-clinical and socioeconomic factors associated with the choice of day surgery. Updates Surg, 2023, 75(1): 65-75.
12. Zhong Y, He M, Liu Z, et al. Efficacy of laparoscopic inguinal hernia in day surgery mode and inpatient surgery mode in China: a meta-analysis. Medicine (Baltimore), 2023, 102(8): e32998.
13. 鄧先銳, 鄭磊, 徐通海, 等. 日間手術模式在腹股溝疝修補術中的應用價值. 中華消化外科雜志, 2023, 22(9): 1075-1079.
14. 青海國土經略. 青海省發布《青海省第一次全國地理國情普查公報》. 青海國土經略, 2017(5): 92-93.
15. 張英. 高原環境血紅蛋白變化的若干研究. 高原醫學雜志, 2008(2): 62-64.
16. 于均濤, 丹珠永吉, 徐妮, 等. 海南州貴德縣 1612 名健康成人靜脈血紅細胞、血紅蛋白、血小板計數參考值范圍及影響因素調查. 職業與健康, 2020, 36(11): 1519-1521,1526.
17. 屈振武, 趙永奎, 郭志偉. 基于傾向性評分匹配對比不同年齡分層中 TAPP 治療老年腹股溝疝的臨床效果. 中國老年學雜志, 2025, 45(2): 330-333.
18. 張天昊, 郝志偉, 安杰, 等. 老年腹股溝疝術后并發癥風險列線圖預測模型的建立及驗證. 腹腔鏡外科雜志, 2024, 29(6): 451-456.
19. Akunov A, Sydykov A, Toktash T, et al. Hemoglobin changes after long-term intermittent work at high altitude. Front Physiol, 2018, 9: 1552.
20. Treml B, Wallner B, Blank C, et al. The influence of environmental hypoxia on hemostasis-a systematic review. Front Cardiovasc Med, 2022, 9: 813550.
21. Fan N, Liu C, Ren M. Effect of different high altitudes on vascular endothelial function in healthy people. Medicine (Baltimore), 2020, 99(11): e19292.
22. De Pablo-Moreno JA, Serrano LJ, Revuelta L, et al. The vascular endothelium and coagulation: homeostasis, disease, and treatment, with a focus on the von willebrand factor and factors VⅢ and Ⅴ. Int J Mol Sci, 2022, 23(15): 8283.
23. Hillary TM, Vanhoutvin T, Peeters M, et al. A prospective, monocentric case-control study on uncontrolled psoriasis as independent risk factor for a hypercoagulable state. Dermatol Ther (Heidelb), 2024, 14(3): 767-775.
24. Kamani F, Ghorbani H, Mahmoudabadi FD, et al. Modified Lichtenstein hernioplasty with concomitant tissue repair: a retrospective study on postoperative chronic pain. BMC Surg. 2024, 24(1): 222.
25. Li J. Patient-reported chronic pain after open inguinal hernia repair with lightweight or heavyweight mesh: a prospective, patient-reported outcomes study. Br J Surg, 2020, 107(13): e657.
26. Elmessiry MM, Gebaly AA. Laparoscopic versus open mesh repair of bilateral primary inguinal hernia: a three-armed randomized controlled trial. Ann Med Surg (Lond), 2020, 59: 145-150.
27. 寧彩虹, 黃耿文, 林嘉晏, 等. 腹腔鏡經腹腹膜前疝修補日間手術的臨床價值分析. 中國普通外科雜志, 2021, 30(4): 399-405.
28. 李為明, 許青文, 李奕俊, 等. 腹腔鏡腹股溝疝修補術日間手術模式的臨床效益評價. 中華疝和腹壁外科雜志(電子版), 2021, 15(1): 19-21.
29. Guttadauro A, Maternini M, Lo Bianco G, et al. 15 years experience in proctological day-surgery. Ann Ital Chir, 2018, 89: 324-329.

West China Medical Journal

Latest ArticlesSafety and efficacy of day surgery laparoscopic transabdominal preperitoneal repair in high-altitude areas

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