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改良衰弱指数和白蛋白-纤维蛋白原比值预测腹腔镜经腹腹膜前疝修补术后血清肿。

Modified Frailty Index and Albumin-Fibrinogen Ratio Predicts Postoperative Seroma After Laparoscopic TAPP.

机构信息

Department of Hernia and Pediatric Surgery, Taizhou People's Hospital, Taizhou Clinical Medical School of Nanjing Medical University, Taizhou City, Jiangsu Province, 225300, People's Republic of China.

出版信息

Clin Interv Aging. 2023 Aug 22;18:1397-1403. doi: 10.2147/CIA.S418338. eCollection 2023.

Abstract

BACKGROUND

Postoperative seroma is the most common minor complication after inguinal hernia repair surgery and can have negative consequences. The objective of this study was to identify potential risk factors for postoperative seroma.

METHODS

This study consecutively included 354 elderly patients with inguinal hernia who underwent laparoscopic Transabdominal preperitoneal Patch Plasty (TAPP). Seroma diagnosis was conducted by the same experienced surgeon based on the physical examinations combined with ultrasound. Risk factors for seroma were identified through univariate analysis and subsequently included in the binary multivariate logistic regression model.

RESULTS

A total of 40 patients experienced postoperative complications of seroma, with an incidence rate of 11.3% (40/354). The binary logistic regression analysis revealed that obesity (OR: 2.98, 95% CI: 1.20-7.41, P = 0.018), disease duration ≥ 4.5 years (OR: 4.88, 95% CI: 2.14-11.18, P < 0.001), albumin-fibrinogen ratio (AFR) level < 9.25 (OR: 6.13, 95% CI: 2.00-18.76, P = 0.001), and modified frailty index (mFI) score ≥ 0.225 (OR: 6.38, 95% CI: 2.69-15.10, P < 0.001) were four independent risk factors for postoperative seroma.

CONCLUSION

Obesity, prolonged disease duration, decreased AFR level, and increased mFI score independently predict postoperative seroma after laparoscopic TAPP.

摘要

背景

术后血清肿是腹股沟疝修补术后最常见的轻微并发症,并可能产生负面影响。本研究旨在确定术后血清肿的潜在危险因素。

方法

本研究连续纳入 354 例老年腹股沟疝患者,均行腹腔镜经腹腹膜前补片修补术(TAPP)。血清肿的诊断由同一位经验丰富的外科医生根据体格检查结合超声检查进行。通过单因素分析确定血清肿的危险因素,然后将其纳入二元多变量逻辑回归模型。

结果

共有 40 例患者发生术后血清肿并发症,发生率为 11.3%(40/354)。二元逻辑回归分析显示,肥胖(OR:2.98,95%CI:1.20-7.41,P=0.018)、疾病持续时间≥4.5 年(OR:4.88,95%CI:2.14-11.18,P<0.001)、白蛋白-纤维蛋白原比值(AFR)水平<9.25(OR:6.13,95%CI:2.00-18.76,P=0.001)和改良衰弱指数(mFI)评分≥0.225(OR:6.38,95%CI:2.69-15.10,P<0.001)是术后血清肿的四个独立危险因素。

结论

肥胖、疾病持续时间延长、AFR 水平降低和 mFI 评分升高独立预测腹腔镜 TAPP 后术后血清肿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba1e/10460205/2960b9c291be/CIA-18-1397-g0001.jpg

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