Liang C, Zheng R, Liu X, Ma Q, Chen J, Shen Y
Department of Hernia and Abdominal Wall Surgery, Beijing Chao-Yang Hospital, No. 5 JingYuan Road, Shijingshan District, Beijing, 100043, China.
Department of Hernia and Abdominal Wall Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
Hernia. 2024 Feb;28(1):119-126. doi: 10.1007/s10029-023-02908-7. Epub 2023 Oct 17.
Patients with liver cirrhosis sometimes suffer from high recurrence rates and postoperative complications. We previously reported that platelet-related hematological parameters are associated with the outcomes after incisional herniorrhaphy, and aim to evaluate the predictive value of these criteria in cirrhotic patients undergoing open umbilical herniorrhaphy.
This is a retrospective study. The data of 95 cirrhotic patients undergoing open umbilical herniorrhaphy were analyzed. Patients were grouped based on the recurrence and defined hematological values. Platelet-multiple-lymphocyte index (PLM), neutrophil-leukocyte ratio, lymphocyte-monocyte ratio, platelet-neutrophil ratio, systemic immune-inflammation index, and aspartate aminotransferase-leukocyte ratio values were calculated based on preoperative blood analyses. The outcomes were obtained from hospital records and follow-up calls to patients.
Using cutoff values acquired by the Youden Index, we found a PLM value < 27.9, and the history of inguinal herniorrhaphy were revealed to be statistically significant in the recurrence based on univariant and multivariant analyses (p < 0.05). We further divided patients into two groups based on the cutoff value of PLM and found that a PLM value < 27.9 was significantly associated with the recurrence of incisional hernias (p = 0.018) and the occurrence of postoperative foreign sensation (p = 0.044), and tended to result in other postoperative complications such as cardiopathy, respiratory infection, hypoproteinemia, and hepatic diseases (p = 0.089).
The preoperative hematological values, especially PLM, may indicate the outcomes in cirrhotic patients after open umbilical herniorrhaphy. Accurate identification of risks may alert the intraoperative and postoperative care for patients.
肝硬化患者有时会出现高复发率和术后并发症。我们之前报道过血小板相关血液学参数与切口疝修补术后的预后相关，旨在评估这些指标在接受开放性脐疝修补术的肝硬化患者中的预测价值。
这是一项回顾性研究。分析了95例接受开放性脐疝修补术的肝硬化患者的数据。根据复发情况和定义的血液学值对患者进行分组。基于术前血液分析计算血小板-淋巴细胞指数（PLM）、中性粒细胞-白细胞比率、淋巴细胞-单核细胞比率、血小板-中性粒细胞比率、全身免疫炎症指数和天冬氨酸转氨酶-白细胞比率值。结果从医院记录和对患者的随访电话中获得。
使用约登指数获得的临界值，我们发现PLM值<27.9，并且腹股沟疝修补术史在单变量和多变量分析中显示出与复发具有统计学意义（p<0.05）。我们进一步根据PLM的临界值将患者分为两组，发现PLM值<27.9与切口疝复发（p = 0.018）和术后异物感的发生（p = 0.044）显著相关，并倾向于导致其他术后并发症，如心脏病、呼吸道感染、低蛋白血症和肝脏疾病（p = 0.089）。
术前血液学值，尤其是PLM，可能预示肝硬化患者开放性脐疝修补术后的预后。准确识别风险可能会提醒对患者进行术中及术后护理。
