腹腔镜完全腹膜外疝修补术后血清肿的危险因素分析

Analysis of risk factors of seroma after laparoscopic totally extraperitoneal hernia repair

目的探讨影响腹腔镜完全腹膜外疝修补术后血清肿形成的危险因素。方法回顾性分析青岛市胶州中心医院2018年7月至2021年6月236例行腹腔镜完全腹膜外疝修补术患者的临床资料,分析影响术后血清肿形成的危险因素。结果 236例患者术后发生血清肿36例(血清肿组),发生率为15.25%;未发生血清肿200例(无血清肿组)。两组病程≥5年、阴囊疝、内环缺损≥3 cm、疝囊离断、术者手术经验<5年比较差异有统计学意义(P<0.01或<0.05);两组年龄、体质量、补片类型、术前合并症(糖尿病、慢性阻塞性肺疾病和心脑血管疾病)和手术时间比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,病程≥5年、阴囊疝、疝囊离断和术者手术经验<5年是影响腹腔镜完全腹膜外疝修补术后血清肿形成的独立因素(OR = 5.147、5.006、0.044和3.315,95%CI 1.513~17.516、1.845~13.583、0.008~0.240和1.029~10.679,P<0.01或<0.05)。结论病程≥5年、阴囊疝、疝囊离断和术者手术经验<5年为影响腹腔镜完全腹膜外疝修补术后血清肿形成的独立因素,术前正确评估相关危险因素有助于减少血清肿的发生。

Objective To explore the risk factors of seroma after laparoscopic totally extraperitoneal hernia repair.Methods The clinical data of 236 patients underwent laparoscopic totally extraperitoneal hernia repair from July 2018 to June 2021 in Jiaozhou Central Hospital of Qingdao City were retrospectively analyzed.The related risk factors of seroma after laparoscopic totally extraperitoneal hernia repair were analyzed.Results Among 236 patients,the seroma occurred in 36 cases(seroma group),the incidence of seroma was 15.25%;no seroma occurred in 200 cases(non-seroma group).There were statistical differences in the duration of disease≥5 years,scrotal hernia,internal inguinal ring defect≥3 cm,rupture of hernia sac,experience of operators<5 years between 2 groups(P<0.01 or<0.05);there were no statistical difference in age,body mass,type of patch,preoperative complications(including diabetes,chronic obstructive pulmonary disease and cardiac cerebrovascular disease)and operative time between 2 groups(P>0.05).Multivariate Logistic regression analysis result showed that the duration of disease≥5 years,scrotal hernia,rupture of hernia sac and experience of operators<5 years were independent influencing factors of seroma after laparoscopic totally extraperitoneal hernia repair(OR=5.147,5.006,0.044 and 3.315;95%CI 1.513 to 17.516,1.845 to 13.583,0.008 to 0.240 and 1.029 to 10.679;P<0.01 or<0.05).Conclusions The duration of disease≥5 years,scrotal hernia,rupture of hernia sac and experience of operators<5 years are independent influencing factors of seroma after laparoscopic totally extraperitoneal hernia repair,and preoperative assessment of risk factors is helpful to reduce the incidence of seroma.