Ergül Z, Akinci M, Yilmaz K B, Sahin A, Seker G, Kulaçoğlu H
Ankara Diskapi Teaching and Research Hospital, Department of General Surgery, Ankara, Turkey.
Chirurgia (Bucur). 2011 Nov-Dec;106(6):769-74.
There is no consensus among surgeons on the indication of putting drains for in groin hernias. In this study we aimed to investigate the factors that are associated with drain usage by comparing the clinical characteristics of patients who had drains with the patients without drains in the repair of groin hernias.
The data of all groin hernia repairs from January 2006 till February 2010 in Ankara Diskapi Research Hospital were collected prospectively. The type of presentation, age, gender, presence of coexisting diseases, type of hernia, American Society of Anesthesiologists (ASA) class, type of anesthesia, postoperative general complications, local wound complications, duration of operation, and length of hospitalization, recurrence and mortality were compared between the groups of patients with drains versus without drains.
The drains were used in 66 (8.3%) of 795 open mesh repairs of inguinal hernias. The patients who had drains were older, had cardiovascular disease, higher ASA class, received anticoagulant regimens more often, had indirect type hernia more often, more recurrent hernias, more commonly had emergency operations, had complicated presentations such as incarceration and strangulation, therefore had resections more often, pulmonary complications, had local complications such as hematoma, had longer duration of the operations and stayed longer in the hospital when compared with the patients without drains (p < 0.05). Anticoagulant use, duration of the operation, recurrent hernias and ASA class were statistically significant independent variables predicting drain use in inguinal hernias (p < 0.05). When femoral hernia repairs (n = 35) were analysed; drains were associated with male gender and long operation time (p < 0.05).
Drains are more commonly used in patients on anticoagulants, who had long duration of the operation, recurrent hernias and high ASA class. Drain use in selected patients seems to not increase infection risk but are associated with longer hospital stay.
外科医生对于腹股沟疝修补术中放置引流管的指征尚无共识。在本研究中，我们旨在通过比较腹股沟疝修补术中放置引流管患者与未放置引流管患者的临床特征，来探究与引流管使用相关的因素。
前瞻性收集了2006年1月至2010年2月安卡拉迪斯科皮研究医院所有腹股沟疝修补术的数据。比较了放置引流管组与未放置引流管组患者的临床表现类型、年龄、性别、并存疾病情况、疝的类型、美国麻醉医师协会（ASA）分级、麻醉类型、术后全身并发症、局部伤口并发症、手术时长、住院时间、复发率及死亡率。
在795例腹股沟疝开放网片修补术中，66例（8.3%）使用了引流管。与未放置引流管的患者相比，放置引流管的患者年龄更大、患有心血管疾病、ASA分级更高、更常接受抗凝治疗、更常为间接型疝、复发疝更多、急诊手术更常见、有嵌顿和绞窄等复杂表现因而更常进行切除术、有肺部并发症、有血肿等局部并发症、手术时间更长且住院时间更长（p < 0.05）。抗凝治疗的使用、手术时长、复发疝及ASA分级是预测腹股沟疝引流管使用的具有统计学意义的独立变量（p < 0.05）。在分析股疝修补术（n = 3５）时，引流管的使用与男性性别及手术时间长相关（p < 0.05）。
引流管更常用于接受抗凝治疗、手术时间长、有复发疝且ASA分级高的患者。在特定患者中使用引流管似乎不会增加感染风险，但与住院时间延长有关。
