腹腔镜经腹腹膜前腹股沟疝修补术中缝合假性疝囊对血清肿的影响

Effects of false hernia sac suturing on seroma during laparoscopic transabdominal preperitoneal inguinal hernia repair

目的:观察腹腔镜经腹腹膜前腹股沟疝修补术(TAPP)中缝合假性疝囊对血清肿的影响。方法:选取86例腹股沟疝患者为研究对象,按根据随机数字表法将其分为对照组和观察组各43例。两组均采用TAPP治疗,对照组术中不缝合假性疝囊,观察组术中缝合假性疝囊,比较两组围术期指标[手术时间、术中出血量、住院时间]水平、术后疼痛[疼痛数字评分法(NRS)]评分、术后3个月内血清肿发生率、血清肿积液量和术后3个月内并发症发生率。结果:两组手术时间、术中出血量和住院时间比较,差异均无统计学意义(P>0.05);术后7 d,两组NRS评分均低于术后1 d,差异有统计学意义(P<0.05);术后1、7 d,两组间NRS评分比较,差异无统计学意义(P>0.05);观察组血清肿发生率为9.30%(4/43),低于对照组的30.23%(13/43),差异有统计学意义(P<0.05);观察组血清肿积液量为(6.84±0.16)mL,少于对照组的(12.97±4.02)mL,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:TAPP手术中缝合假性疝囊可降低血清肿发生率和血清肿积液量。

Objective:To observe effects of false hernia sac suturing on seroma during laparoscopic transabdominal preperitoneal inguinal hernia repair(TAPP).Methods:86 patients with inguinal hernia were selected as the research objects,and were divided into control group and observation group according to the random number table method,43 cases in each group.Both groups were treated with TAPP.The false hernia sac in the control group was not sutured during the surgery,while the pseudo hernia sac in the observation group was sutured.The levels of perioperative indicators(operation time,intraoperative blood loss,hospitalization time),the postoperative pain[number of pain scores(NRS)1 and 7 days after the surgery],the incidence of seroma,the seroma volume,and the incidence of complications within 3 months after the surgery were compared between the two groups.Results:There were no significant differences in the operation time,the intraoperative blood loss and the hospitalization time between the two groups(P>0.05).7 days after the surgery,the NRS scores of the two groups were lower than those 1 day after the surgery,and the differences were statistically significant(P<0.05).There was no significant difference in the NRS score between the two groups 1 and 7 days after the surgery(P>0.05).The incidence of seroma in the observation group was 9.30%(4/43),which was lower than 30.23%(13/43)in the control group,and the difference was statistically significant(P<0.05).The seroma volume in the observation group was(6.84±0.16)mL,which was less than(12.97±4.02)mL in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:The false hernia sac suturing during TAPP can reduce the incidence of seroma and the seroma volume.