Department of Hernia and Pediatric Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou Clinical Medical School of Nanjing Medical University, No. 366 Taihu Road, Taizhou City, 225300, Jiangsu Province, China.
Hernia. 2024 Oct;28(5):1961-1967. doi: 10.1007/s10029-024-03134-5. Epub 2024 Aug 23.
Formation of seroma/hematoma is one of the most common postoperative complications following laparoscopic inguinal hernia repair. This study aimed to identify risk factors associated with seroma/hematoma and construct a prediction model.
Elderly subjects undergoing laparoscopic Transabdominal preperitoneal Patch Plasty (TAPP) were included in this study. The observation endpoint was set as the occurrence of seroma/hematoma within 3 months after TAPP surgery. Independent risk factors were identified through preliminary univariate screening and binary logistic regression analysis. These risk factors were then used to construct a nomogram predictive model using R software.
A total of 330 patients were included in the analysis, of which 51 developed seroma/hematoma, resulting in an incidence rate of 15.5%. Obesity (OR: 3.54, 95%CI: 1.45-8.66, P = 0.006), antithrombotic drug use (OR: 2.73, 95%CI: 1.06-7.03, P = 0.037), C-reactive protein (CRP) ≥ 8 (OR: 2.72, 95%CI: 1.04-7.10, P = 0.041, albumin/fibrinogen ratio (AFR) < 7.85 (OR: 2.99, 95%CI: 1.28-7.00, P = 0.012), and lymphocyte/monocyte ratio (LMR) < 4.05 (OR: 12.62, 95%CI: 5.69-28.01, P < 0.001) were five independent risk factors for seroma/hematoma. The nomogram model has well predictive value for seroma/hematoma, with an AUC of 0.879.
The nomogram model based on obesity, antithrombotic drug, CRP, AFR, and LMR has a proved good predictive value and it has potential in clinical practice.
血清肿/血肿的形成是腹腔镜腹股沟疝修补术后最常见的并发症之一。本研究旨在确定与血清肿/血肿相关的危险因素，并构建预测模型。
本研究纳入了接受腹腔镜经腹腹膜前补片修补术（TAPP）的老年患者。观察终点设定为 TAPP 手术后 3 个月内发生血清肿/血肿。通过初步单因素筛选和二元逻辑回归分析确定独立危险因素。然后使用 R 软件构建列线图预测模型。
共纳入 330 例患者，其中 51 例发生血清肿/血肿，发生率为 15.5%。肥胖（OR：3.54，95%CI：1.45-8.66，P=0.006）、使用抗血栓药物（OR：2.73，95%CI：1.06-7.03，P=0.037）、C 反应蛋白（CRP）≥8（OR：2.72，95%CI：1.04-7.10，P=0.041）、白蛋白/纤维蛋白原比值（AFR）<7.85（OR：2.99，95%CI：1.28-7.00，P=0.012）和淋巴细胞/单核细胞比值（LMR）<4.05（OR：12.62，95%CI：5.69-28.01，P<0.001）是血清肿/血肿的五个独立危险因素。列线图模型对血清肿/血肿具有良好的预测价值，AUC 为 0.879。
基于肥胖、抗血栓药物、CRP、AFR 和 LMR 的列线图模型具有良好的预测价值，在临床实践中有一定的应用潜力。
