Xie Hong-Yang, Chen Bin, Shen Jie, Wang Yi-Ping, Shen Wei-Cai, Dai Chun-Shan
Department of Gastrointestinal Surgery, Ningbo Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Ningbo, Zhejiang, 315016, China.
BMC Surg. 2024 Oct 1;24(1):274. doi: 10.1186/s12893-024-02574-1.
Although laparoscopic inguinal hernia repair (LIHR) has advantages over open surgery, postoperative seroma formation remains an issue. This study aimed to investigate the risk factors and clinical outcomes of seroma formation in patients undergoing LIHR.
From January 2016 to March 2023, clinical data of patients who underwent LIHR were retrospectively analyzed. Patients who developed seroma and those who did not were classified into the seroma and non-seroma groups, respectively. The demographic and clinical characteristics were compared between the two groups. Univariate and multivariate logistic regression analyses were performed for variables of interest. The receiver operating characteristic curve was used to evaluate the risk factors of the binary logistic model, and the cutoff value for each risk factor was obtained.
Data of 128 patients were evaluated. Compared with patients in the non-seroma group, those in the seroma group had a higher body mass index (BMI) (P < 0.001), more direct hernias (P < 0.001), larger hernial orifice size (P < 0.001), more laparoscopic total extraperitoneal hernioplasty (TEP) (P < 0.001), more frequent reduction of hernial sac (P = 0.011), and lower preoperative serum albumin level (PSAL) (P < 0.001). Multivariate logistic regression analyses performed on these variables showed that high BMI (P = 0.005), large hernial orifice (P = 0.001), TEP (P = 0.033), and low PSAL (P = 0.009) were risk factors for seroma formation. Compared with the non-seroma group, the seroma group exhibited a higher numerical rating scale score for postoperative pain (P < 0.001), and longer hospital stays (P = 0.032).
BMI (> 24.5 kg/m), hernial orifice size (> 2.5 cm), TEP, and PSAL (< 32.5 g/L) were independent risk factors of postoperative seroma formation in patients who underwent LIHR. Although most seromas resolve spontaneously without surgical intervention, seroma formation results in increased patient pain and prolonged hospital stay.
尽管腹腔镜腹股沟疝修补术（LIHR）相较于开放手术具有优势，但术后血清肿形成仍是一个问题。本研究旨在调查接受LIHR患者血清肿形成的危险因素及临床结局。
回顾性分析2016年1月至2023年3月期间接受LIHR患者的临床资料。发生血清肿的患者和未发生血清肿的患者分别被纳入血清肿组和非血清肿组。比较两组的人口统计学和临床特征。对感兴趣的变量进行单因素和多因素逻辑回归分析。采用受试者工作特征曲线评估二元逻辑模型的危险因素，并获得各危险因素的截断值。
评估了128例患者的数据。与非血清肿组患者相比，血清肿组患者的体重指数（BMI）更高（P<0.001），直疝更多（P<0.001），疝孔尺寸更大（P<0.001），腹腔镜完全腹膜外疝修补术（TEP）更多（P<0.001），疝囊还纳更频繁（P=0.011），术前血清白蛋白水平（PSAL）更低（P<0.001）。对这些变量进行的多因素逻辑回归分析表明，高BMI（P=0.005）、大疝孔（P=0.001）、TEP（P=0.033）和低PSAL（P=0.009）是血清肿形成的危险因素。与非血清肿组相比，血清肿组术后疼痛的数字评定量表评分更高（P<0.001），住院时间更长（P=0.032）。
BMI（>24.5kg/m²）、疝孔尺寸（>2.5cm）、TEP和PSAL（<32.5g/L）是接受LIHR患者术后血清肿形成的独立危险因素。尽管大多数血清肿无需手术干预即可自行消退，但血清肿形成会导致患者疼痛加剧和住院时间延长。
