Cao Rui, Shao Xiangyu, Li Junsheng
School of Medicine, Southeast University, Nanjing, 210009, China.
Department of Abdominal Wall and Hernia Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China.
Hernia. 2024 Dec 30;29(1):60. doi: 10.1007/s10029-024-03236-0.
Seroma formation is a prevalent postoperative complication following laparoscopic inguinal hernia repair. While seromas are mostly self-absorbed, they can cause discomfort for the patient and complicate the assessment of hernia recurrence. Two primary techniques for managing the hernia sac are sac transection and complete sac reduction. This article aims to evaluate whether sac transection leads to a higher incidence of seroma compared to sac reduction and to review the main preventive strategies for seroma.
Four databases (PubMed, MEDLINE, Embase and Cochrane Library) and ClinicalTrials.gov were comprehensively searched for relevant studies. The date of the last search was 25 March 2024. The results reported should include reliable information on seroma incidence, mean operation time, hospital stay and postoperative complications.
The present study included 6 studies compared the results of indirect hernia sac transection and complete sac reduction. The pooled results indicated that indirect hernia sac transection was associated increased seroma formation (OR = 1.74, 95% CI: 1.35-2.24%), and there was no statistical difference in mean operation time, hospital stay and recurrence between the sac transection (TS) and sac reduction (RS) groups. Postoperative pain was evaluated in 4 studies. There was no statistical difference between the two groups in postoperative pain reported in each of the four articles.
The study revealed that transection of the indirect hernia sac is associated with a higher incidence of seroma, but does not increase the occurrence of other complications.
血清肿形成是腹腔镜腹股沟疝修补术后常见的并发症。虽然血清肿大多可自行吸收，但会给患者带来不适，并使疝复发的评估变得复杂。处理疝囊的两种主要技术是囊横断术和完全囊还纳术。本文旨在评估与囊还纳术相比，囊横断术是否会导致血清肿发生率更高，并综述血清肿的主要预防策略。
全面检索了四个数据库（PubMed、MEDLINE、Embase和Cochrane图书馆）以及ClinicalTrials.gov上的相关研究。最后一次检索日期为2024年3月25日。报告的结果应包括有关血清肿发生率、平均手术时间、住院时间和术后并发症的可靠信息。
本研究纳入了6项比较间接疝囊横断术和完全囊还纳术结果的研究。汇总结果表明，间接疝囊横断术与血清肿形成增加相关（OR = 1.74，95% CI：1.35 - 二点二四%），囊横断术（TS）组和囊还纳术（RS）组在平均手术时间、住院时间和复发率方面无统计学差异。4项研究对术后疼痛进行了评估。在这四篇文章中，两组报告的术后疼痛无统计学差异。
该研究表明，间接疝囊横断术与血清肿发生率较高相关，但不会增加其他并发症的发生。
