腹膜前引流对腹腔镜经腹腹膜前疝修补术患者术后血肿及血清肿的影响

Effect of preperitoneal drainage on postoperative hematoma and seroma in patients undergoing laparoscopic transabdominal preperitoneal repair:A prospective randomized controlled study

目的探讨腹腔镜经腹腹膜前疝修补术(TAPP)放置腹膜前引流对术后血肿及血清肿的影响。方法选取2016年6月至2018年5月,江苏省苏州市中西医结合医院收治的单侧腹股沟疝患者90例,随机分为试验组和对照组,2组患者均行TAPP手术。试验组放置腹膜前引流管,对照组不放置引流管。收集2组患者的一般资料、手术相关资料及随访资料进行统计学分析,对比2组患者术后血肿及血清肿发生率差异。结果全部患者均完成手术及随访。2组患者的一般资料、疝位置、疝分型、手术时间、住院花费、术后住院时间差异无统计学意义(P>0.05)。2组患者的术后发热发生率、急性疼痛发生率差异无统计学意义(P>0.05)。试验组术后血肿发生率明显低于对照组(P<0.05),试验组患者术后1和3个月血清肿发生率明显低于对照组,差异有统计学意义(P<0.05)。2组患者1年随访均观察到1例复发的病例,差异无统计学意义(P>0.05);随访期内2组患者均未出现感染的病例。结论TAPP中,放置腹膜前引流管能够有效降低患者术后血肿和血清肿的发生率,同时并不增加感染和复发风险。

Objective To investigate the effect of peritoneal drainage in laparoscopic transabdominal preperitoneal hernia repair for postoperative hematoma and seroma.Methods A total of 90 patients with unilateral inguinal hernia admitted to Suzhou hospital of integrated traditional Chinese and Western medicine from June 2016 to May 2018 were selected and randomly divided into experimental group and control group.Both groups underwent TAPP surgery.Preperitoneal drainage tube was placed in the experimental group,while no drainage tube was placed in the control group.The general data,operative related data and follow-up data of the two groups were collected for statistical analysis,and the incidence of postoperative hematoma and seroma was compared between the two groups.Results Surgery and follow-up were completed in all patients,and the follow-up rate was 100%.There were no statistically significant differences between the two groups in general data,hernia location,hernia type,operation time,hospitalization cost,and postoperative hospitalization time(P>0.05).There was no statistically significant difference between the two groups in the incidence of postoperative fever and acute pain(P>0.05).The incidence of postoperative hematoma in the experimental group was significantly lower than that in the control group(P<0.05),and the incidence of postoperative seroma in the experimental group was significantly lower than that in the control group at 1 month and 3 months after surgery(P<0.05),with statistically significant differences.One case of recurrence was observed in both groups during 1-year follow-up,and the difference was not statistically significant.There was no case of infection in both groups during the follow-up period.Conclusion During laparoscopic transabdominal preperitoneal repair,the placement of a preperitoneal drainage tube can effectively reduce the incidence of postoperative hematoma and seroma without increasing the risk of infection and recurrence.