Morales-Conde S, Suarez-Artacho G, Socas-Macias M, Barranco-Moreno A
Unit of Innovation and Minimally Invasive Surgery, Hospital Universitary Virgen Del Rocío, Avenida Manuel Siurot, CP 41013, Seville, Spain.
Hernia. 2015 Dec;19(6):943-7. doi: 10.1007/s10029-015-1352-y. Epub 2015 Feb 10.
The seroma generated between the abdominal viscera and the prosthesis (retroprosthetic seroma), after laparoscopic ventral hernia repair (LVHR) with the implant of an intraperitoneal mesh is an unknown entity with few references in the literature. Our objective is to analyze its incidence, clinical repercussions and course of retroprosthetic seroma during the first 3 months post-operation and the factors related to its appearance, such as the relationship to preprosthetic seroma, the size of the prosthesis and the patient BMI.
Prospective, descriptive study in patients undergoing LVHR using the double crown technique. After surgery, the patients had follow-ups on the seventh day and the first and third months post-operation with clinical examination and abdominal CT scan. The study endpoints were: incidence and volume of retroprosthetic seroma, clinical repercussions, relationship to body mass index (BMI), prosthesis size and the existence of preprosthetic seroma.
Fifty patients underwent LVHR using the double crown technique and were included in the study. The incidence of retroprosthetic seroma during the 3-month follow-up was 46%, there being a progressive process of spontaneous reabsorption. In just one patient (2%) there were clinical repercussions as a result of the seroma. No statistically significant relationship was found with BMI and preprosthetic seroma. A statistical relationship was found between the size of the prosthesis and the risk of suffering retroprosthetic seroma in the third month post-operation (p = 0.048).
Retroprosthetic seroma is an entity produced in 46% of patients undergoing LVHR with few clinical repercussions (2%). In most cases it develops in the first week post-operation and then undergoes a reabsorption process that is usually complete by the third month post-operation. The size of the prosthesis delays the reabsorption process.
腹腔镜腹疝修补术（LVHR）植入腹膜内补片后，腹内脏器与补片之间形成的血清肿（补片后血清肿）是一种未知实体，在文献中鲜有提及。我们的目的是分析术后前3个月补片后血清肿的发生率、临床影响及病程，以及与血清肿出现相关的因素，如与补片前血清肿的关系、补片大小和患者体重指数（BMI）。
对采用双冠技术行LVHR的患者进行前瞻性描述性研究。术后，患者在第7天以及术后第1个月和第3个月进行随访，包括临床检查和腹部CT扫描。研究终点包括：补片后血清肿的发生率和体积、临床影响、与体重指数（BMI）的关系、补片大小以及补片前血清肿的存在情况。
50例患者采用双冠技术行LVHR并纳入研究。3个月随访期间补片后血清肿的发生率为46%，存在自发吸收的渐进过程。仅1例患者（2%）因血清肿出现临床影响。未发现与BMI和补片前血清肿有统计学意义的关系。发现补片大小与术后第3个月发生补片后血清肿的风险之间存在统计学关系（p = 0.048）。
补片后血清肿在46%的LVHR患者中出现，临床影响较小（2%）。在大多数情况下，它在术后第一周出现，然后经历吸收过程，通常在术后第三个月完成。补片大小会延迟吸收过程。
