预防腹腔镜完全腹膜外疝修补术后血清肿的回顾性研究

摘要/Abstract

摘要：

目的：探讨术中放置负压引流管对预防腹腔镜完全腹膜外（TEP）疝修补术后血清肿的疗效。方法：选取2022年1月至2022年12月在本院接受TEP术的200例病人，分为两组，每组100例。研究组TEP术中放置负压引流管，对照组不放置。观察比较两组的治疗效果及术后并发症的发生情况。结果：两组手术时间、疼痛评分、切口感染发生率和复发率差异均无统计学意义（P>0.05）。与对照组相比，研究组术后血清肿的发生率明显降低（P<0.05）。对于直疝，研究组手术时间明显短于对照组（P<0.05）。两组均未观察到补片感染。结论：预防性放置负压引流管明显减少血清肿的发生，且不增加其他术后并发症，操作方便。对于阴囊疝和直疝，建议放置负压引流管。

关键词:腹腔镜完全腹膜外疝修补术,腹股沟疝,血清肿,负压引流

Abstract:

ObjectiveTo evaluate the efficacy of intraoperative negative pressure drainage in preventing seroma after laparoscopic totally extraperitoneal (TEP) hernia repair.MethodsA total of 200 patients undergoing TEP repair in our hospital from January 2022 to December 2022 were divided into two groups (n=100 each). The study group received intraoperative negative pressure drainage, while the control group did not. Therapeutic outcomes and postoperative complications were compared between the two groups.ResultsThere were no significant differences between the two groups in operative time, pain scores, incidence of wound infection, or recurrence rates (P> 0.05). However, the study group showed a significantly lower incidence of postoperative seroma compared to the control group (P< 0.05). For direct hernias, the operative time in the study group was significantly shorter than that in the control group (P< 0.05). No mesh infections were observed in either group.ConclusionsProphylactic negative pressure drainage significantly reduces seroma formation without increasing other postoperative complications and is easy to be performed. The application of negative pressure drainage is recommended in cases of scrotal and direct hernias.

Key words:Laparoscopic totally extraperitoneal(TEP) hernia repair,Inguinal hernia,Seroma,Negative pressure drainage

中图分类号:

R656.2

刘德俊, 胡星辰. 预防腹腔镜完全腹膜外疝修补术后血清肿的回顾性研究[J]. 外科理论与实践, 2025, 30(05): 423-427.

LIU Dejun, HU Xingchen. Prevention of seroma after laparoscopic totally extraperitoneal hernia repair: a retrospective analysis[J]. Journal of Surgery Concepts & Practice, 2025, 30(05): 423-427.

图/表7

Group	Study group(n=100)	Control group(n=100)	Statistical value	Pvalue
Male/Female	97 (97.0) / 3 (3.0)	94 (94.0) / 6 (6.0)	χ²=0.15	>0.05
Indirect hernia/Direct hernia/Compound hernia	76 (76.0) / 20 (20.0) / 4 (4.0)	79 (79.0) / 16 (16.0) / 5 (5.0)	χ²=0.61	>0.05
Routine hernia/Scrotal hernia	85(85.0) / 15(15.0)	84(84.0) / 16(16.0)	-	-
Age (years)	63.8±7.6	64.8±5.3	t=0.35	>0.05
Body mass index (kg/m²)	23.1±2.8	22.8±2.7	t=1.32	>0.05

表1

图1

图2

Type	Study group (n=100)	Control group (n=100)	tvalue	Pvalue
Indirect hernia (min)	36.4±1.2	36.2±1.1	1.01	>0.05
Direct hernia (min)	29.1±0.7	33.4±3.1	-6.01	<0.05
Compound hernia (min)	38.7±0.4	40.7±1.1	0.76	>0.05
Total operative time (min)	34.9±3.2	35.9±2.2	-2.52	>0.05

表2

表3

两组疼痛评分[n (%)]

Time point	Pain score	Study group (n=100)	Control group (n=100)	χ² value	Pvalue
24 hours postoperative	1	3 (3.0)	2 (2.0)	0.76	>0.05
	2	75 (75.0)	80 (80.0)
	3	22 (22.0)	18 (18.0)
	4	0	0
	5	0	0
1 week postoperative	1	56 (56.0)	55 (55.0)	0.39	>0.05
	2	42 (42.0)	44 (44.0)
	3	2 (2.0)	1 (1.0)
	4	0	0
	5	0	0

表3

Complication type	Study group (n=100)	Control group (n=100)	χ² value	Pvalue
Urinary retention	4 (4.0)	4 (4.0)	0.00	>0.05
Incision infection	2 (2.0)	1 (1.0)	0.39	>0.05
Mesh infection	0	0	-	-
Hernia recurrence	0	0	-	-

表4

Time point	Study group (n=100) (indirect hernia/direct hernia)	Control group (n=100) (indirect hernia/direct hernia)	χ² value	Pvalue
24 hours postoperative	4 (4/0)	25 (24/1)	17.79	0.000
1 week postoperative	5 (5/0)	30 (29/1)	21.65	0.000
1 month postoperative	1 (1/0)	10 (9/1)	7.79	0.005
3 months postoperative	0	2 (2/0)	2.02	0.155

表5

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