腹腔镜疝修补术术中残端疝囊处理方式对Ⅲ型腹股沟斜疝患者术后血清肿发生的影响

nfluence of stump hernia sac management method during TAPP operation on postoperative seroma in patients with typeⅢindirect inguinal hernia

目的 探讨经腹腔腹膜前腹腔镜疝修补术(transabdominal preperitoneal prosthesis,TAPP)术中残端疝囊处理方式对Ⅲ型腹股沟斜疝患者术后血清肿发生的影响。方法 选取2021年2月—2022年2月咸宁市第一人民医院Ⅲ型腹股沟斜疝患者142例,参照随机数字表法分为A组(n=71)、B组(n=71)。A组予以横断处理,B组予以完全剥离,统计比较2组手术情况、疼痛情况、术后血清肿发生情况、手术前后生活质量评分。结果 A组手术时长、住院时间短于B组,腹股沟区积液、术中出血量少于B组,术后1、3、7 d,A组视觉模拟量表(visual analogue scale,VAS)评分低于B组(P<0.05);A组术后血清肿发生率2.82%低于B组11.27%(P<0.05);术后3个月,A组心理功能、物质生活状态、社会功能、躯体功能评分较B组高(P<0.05)。结论 与完全剥离相比,横断处理应用于Ⅲ型腹股沟斜疝患者TAPP术中残端疝囊处理可缩短手术时间,减少腹股沟区积液及术中出血量,降低术后血清肿发生率,提高患者生活质量,促进患者恢复健康。

Objective To investigate the effect of stump hernia sac management on the occurrence of postoperative seroma in patients with typeⅢindirect inguinal hernia during transabdominal preperitoneal laparoscopic hernia repair(TAPP).Methods A total of 142 patients with type III indirect inguinal hernia in our hospital from February 2021 to February 2022 were selected and divided into group A(n=71)and group B(n=71)according to the random number table method.Group A was treated by transection,and group B was completely stripped.The operation conditions,pain conditions,postoperative seroma occurrence,and quality of life scores before and after operation were compared between the two groups.Results The operation time and hospital stay in group A were shorter than those in group B,and the inguinal effusion and intraoperative blood loss were less than those in group B(P<0.05).The incidence of postoperative seroma in group A was 2.82%lower than 11.27%in group B(P<0.05).3 months after operation in group A,psychological function,material life status,social function,physical function The score was higher than that of group B(P<0.05).Conclusion Compared with complete dissection,transversal treatment applied to the treatment of stump hernia sac during TAPP operation in patients with type III indirect inguinal hernia can shorten the operation time,reduce inguinal fluid accumulation and intraoperative blood loss,reduce the incidence of postoperative seroma,and improve the quality of life of patients,and promote the recovery of patients to health.