腹腔镜腹股沟疝修补术后临床血清肿的防治体会

Clinical experience of prevention and treatment of seroma after laparoscopic inguinal hernia repair

目的：探讨腹腔镜腹股沟疝修补术后发生临床血清肿的相关因素及防治措施。方法回顾性分析2011年7月至2013年7月，汕头市第二人民医院收治并施行经腹腹膜前疝修补术（TAPP）术患者67例临床资料，观察术后1个月内发生临床血清肿情况，分析血清肿的处理方法及预后。结果共发生术后临床血清肿11例，以0-Ⅰ型患者较常见，多数患者在术后无需干预，Ⅲ-Ⅳ型出现在术前疝反复突出、疝囊颈粘连严重患者。仅少数Ⅳ型患者需抽液并加压治疗。结论 TAPP术后血清肿发生因素与患者腹股沟区病变程度相关，术中精细操作及术后早期加压有助于减少血清肿的发生。

Objective To explore the relative factors and preventive measures of seroma after laparoscopic transabdominal preperitoneal hernia repair （TAPP ）.Methods A total of 67 cases who underwent TAPP in the Second People′s Hospital of Shantou from July 201 1 to July 201 3, were retrospectively analyzed.The incidence of seroma at 1 month after operations was observed.The management and prognosis of seroma were analyzed.Results In all the cases,1 1 patients were suffered from seroma after TAPP.However,most of them were type 0 to 1 ,which could cured without any intervention.In type Ⅲ toⅣ,seroma more commonly occurred in the patients who had history of repeated herniation and dense adhesion.Only the patients of type IV needed punctureand compression therapy.Conclusion The occurrence of seroma after TAPP was associated with the preperitoneal groin anatomy of patients.It suggests that good operation in surgery and early postoperative local compression can help to prevent seroma.