Chirurgia (Bucur). 2023 Aug;118(4):426-434. doi: 10.21614/chirurgia.2023.v.118.i.4.p.426.
While ventral hernia repair is a frequent surgical intervention, the possibility of complications remains present. The use of drains to mitigate complications is a topic of debate, with conflicting evidence. This study aimed to evaluate the association between drain usage and postoperative complications in ventral hernia repair. A single-center prospective study included patients undergoing ventral hernia repair from 2018 to 2022. Patient data and surgical techniques were recorded. Statistical analysis was performed to assess risk factors for drain insertion and complications. Of the 216 patients included, 19.44% had diabetes, and 20% had cancer. Postoperative complications (Clavien Dindo grade IIIB) occurred in 9.3% of cases, resulting in a 3.7% mortality. Decision factors for drain insertion included older age, larger hernia size, bowel resection with anastomosis, emergency setting and the need for adhesiolysis. No differences were found between the two groups regarding seroma and hematoma formation and mesh infection. Patients with drains had a longer hospital stay and higher costs. Conclusion: The decision to use drains in ventral hernia repair was influenced by surgical complexity factors rather than patient characteristics. While drain usage did not correlate with postoperative morbidities, it was associated with longer hospitalization and higher costs. Individualized decision-making is crucial to balance complications and resource utilization in ventral hernia repair.
虽然腹疝修补术是一种常见的手术干预，但仍存在并发症的可能性。使用引流管来减轻并发症是一个有争议的话题，存在相互矛盾的证据。本研究旨在评估在腹疝修补术中使用引流管与术后并发症之间的关联。
一项单中心前瞻性研究纳入了 2018 年至 2022 年期间接受腹疝修补术的患者。记录了患者数据和手术技术。进行了统计分析，以评估引流管插入和并发症的风险因素。
在纳入的 216 例患者中，19.44%患有糖尿病，20%患有癌症。9.3%的病例发生术后并发症（Clavien Dindo 分级 IIIB），导致 3.7%的死亡率。引流管插入的决策因素包括年龄较大、疝较大、肠切除吻合、急诊和需要粘连松解。两组在血清肿和血肿形成以及网感染方面没有差异。使用引流管的患者住院时间更长，费用更高。结论：在腹疝修补术中使用引流管的决定受到手术复杂性因素的影响，而不是患者特征的影响。虽然引流管的使用与术后并发症无关，但与更长的住院时间和更高的成本相关。在腹疝修补术中，权衡并发症和资源利用需要个体化决策。
