Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
BMC Surg. 2023 Jan 17;23(1):14. doi: 10.1186/s12893-022-01900-9.
Although laparoscopic total extraperitoneal (TEP) inguinal hernia repair has the advantages of less bleeding, less trauma, less pain, and fast recovery, there are several issues that need to be addressed. This study aims to evaluate the effectiveness of preperitoneal closed‑suction drainage on reducing postoperative complications in TEP inguinal hernia repair.
A retrospective analysis of 122 patients who underwent TEP inguinal hernia repair between June 2018 and June 2021 was performed. The patients were divided into the drainage group and the non-drainage group according to whether the drainage tube was placed or not. Clinical data, surgical procedures and outcome of these patients were collected and analyzed to assess the effectiveness of drainage.
A total of 122 patients undergoing TEP surgery were screened, of which 22 were excluded. Most of the patients were male with right indirect inguinal hernia. There was no difference in the mean length of hospital stay between the two groups. Postoperative pain was alleviated by preperitoneal closed‑suction drainage 24 h after operation (p = 0.03). The rate of complications such as scrotal edema, seroma and urinary retention in the drainage group was significantly lower than that in the non-drainage group (p < 0.05). Multivariate regression analysis showed that drainage was beneficial to reduce postoperative complications (OR, 0.015; 95% CI, 0.002-0.140; p < 0.01). In addition, it was worth noting that in subgroup analysis, patients with hernia sac volume > 10 cm might receive more clinical benefits by placing drainage tube.
In TEP inguinal hernia repair, placing drainage tube is a simple and feasible traditional surgical treatment, which can promote postoperative recovery without increasing the risk of infection, especially in patients with large hernia sac volume.
腹腔镜完全腹膜外(TEP)腹股沟疝修补术具有出血少、创伤小、疼痛轻、恢复快等优点,但仍存在一些需要解决的问题。本研究旨在评估腹膜前闭式引流在减少 TEP 腹股沟疝修补术后并发症方面的有效性。
回顾性分析了 2018 年 6 月至 2021 年 6 月期间接受 TEP 腹股沟疝修补术的 122 例患者的临床资料。根据是否放置引流管将患者分为引流组和非引流组。收集并分析这些患者的临床数据、手术步骤和结果,以评估引流的效果。
共筛选出 122 例行 TEP 手术的患者,其中 22 例被排除。大多数患者为男性,右侧腹股沟斜疝。两组患者的平均住院时间无差异。术后 24 小时腹膜前闭式引流可减轻术后疼痛(p = 0.03)。引流组阴囊水肿、血清肿和尿潴留等并发症的发生率明显低于非引流组(p < 0.05)。多因素回归分析表明,引流有利于减少术后并发症(OR,0.015;95%CI,0.002-0.140;p < 0.01)。此外,值得注意的是,在亚组分析中,疝囊体积>10cm 的患者放置引流管可能会获得更多的临床获益。
在 TEP 腹股沟疝修补术中,放置引流管是一种简单可行的传统手术治疗方法,不会增加感染风险,反而可以促进术后恢复,尤其是在疝囊体积较大的患者中。