负压引流措施对腹腔镜经腹腹膜前疝修补术后临床血清肿发生率的影响

Effect of negative pressure drainage on the incidence of seroma following laparoscopic transabdominal preperitoneal hernia repair

目的探讨负压引流管对减少腹腔镜经腹腹膜前疝修补术(TAPP)患者术后血清肿发生率的影响。方法收集2017年2月至2018年2月,鄂尔多斯市第二人民医院接受TAPP术式的成人单侧腹股沟疝患者50例。引流组患者26例,将十字形负压引流管放置于疝补片与腹膜之间,经过腹膜外从同侧戳卡孔引出接负压;对照组患者24例,未放置引流管。对比分析引流组与对照组患者的手术时间、术后住院时间、术后血清肿发生率。结果50例患者中直疝11例、斜疝39例。引流组平均手术时间[(69.04±3.49)min]较对照组[(64.38±3.41)min]长,但差异无统计学意义(P=0.345)。引流组术后平均住院时间与对照组相仿[(1.69±0.09)dvs(1.71±0.09)d],差异无统计学意义(P=0.904)。术后短期(2d),引流组的血清肿发生率明显低于对照组[2(7.69%)vs8(33.33%)],差异有统计学意义(P=0.032);引流组与对照组术后长期(7、14 d)的血清肿发生率比较,差异无统计学意义[7 d:2(7.69%)vs 5(20.83%),P=0.181;14 d:0 vs 1(4.17%),P=0.302]。结论负压引流可减少TAPP术后早期血清肿的发生,对长期血清肿的发生无明显影响。

Objective Our research was to evaluate whether negative pressure drainage could reduce seroma incidence in patient receiving laparoscopic trans-abdominal preperitoneal(TAPP)hernia repair.Methods The clinical data of 50 cases of patients with unilateral hernia admitted to the Second People's Hospital of Ordos from Feb.2017 to Feb.2018 were collected and assigned to either drainage group(26 cases)or control group(24 cases).A cross-type negative pressure drainage tube was placed between the mesh and peritoneum only in the drainage group patients before peritoneum suture.The data of operative time,hospitalized stay and post-operative seroma incidence was collected and analyzed statistically in the drainage group and the control group.Results Of all 50 cases,11 patients were direct inguinal hernia and 39 were indirect inguinal hernia.The average operative time was longer in the drainage group(69.04±3.49)minutes than that in the control group(64.38±3.41)minutes,however,without significance(P=0.345).The hospitalized stay were similar in both groups(drainage group vs control group:1.69±0.09 days vs 1.71±0.09 days;P=0.904).But the post-operative seroma incidence was significantly lower in the drainage group[7.69%(2/26)]than in the control group[33.33%(8/24)]in short-term period(2 days)after TAPP surgery(P=0.032).While there was no significance in long-term period(7 days,14 days)of comparison between the drainage group and control group after surgery[7 days:drainage vs control:7.69%(2/26)vs 20.83%(5/24),P=0.181;14 days:drainage vs control:0(0/26)vs 4.17%(1/24),P=0.302].Conclusion Negative pressure drainage can reduce the incidence of early post-operative seroma in TAPP repair,while there is no significant effect on long-term post-operative seroma.