标题：Correlation between laparoscopic transection of an indirect inguinal hernial sac and postoperative seroma formation: a prospective randomized controlled study
作者：Ruze, Rexiati; Yan, Zhibo; Wu, Qunzheng; Zhan, Hanxiang; Zhang, Guangyong
作者机构：[Ruze, Rexiati; Yan, Zhibo; Wu, Qunzheng; Zhan, Hanxiang; Zhang, Guangyong] Shandong Univ, Qilu Hosp Shandong, Dept Gen Surg, 107 Wenhua Xi Rd, Jinan 更多
通讯作者地址：[Zhang, GY]Shandong Univ, Qilu Hosp Shandong, Dept Gen Surg, 107 Wenhua Xi Rd, Jinan 250012, Shandong, Peoples R China.
来源：SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
关键词：Inguinal hernia; Seroma; Laparoscopic repair; Hernial sac; TAPP
摘要：BackgroundSeroma is the most common early minor complication of inguinal hernia repair. Seromas generally resolve spontaneously within a few weeks, but can sometimes cause other complications. The optimal ways to repair inguinal hernia and handle the hernial sac are still debatable. Large scale, prospective, randomized, controlled studies focusing on the correlation between transection of the hernial sac and seroma formation are scarce.MethodsA total of 159 adult male patients with primary indirect inguinal hernia who underwent laparoscopic transabdominal preperitoneal repair were recruited. The patients were randomized to undergo either complete dissection or transection of the hernial sacs. Patients were followed up at postoperative 7days, 1 and 3months, looking specifically for seroma. Seroma was diagnosed via physical examination, and a prestructured form was used to evaluate patient recovery and define the type of seroma present at each follow-up visit.ResultsThere were 83 patients in the completely dissected group and 76 in the transected group. The overall incidence of postoperative seroma was 12.6% (n=20). The (2) test demonstrated that significantly more patients developed seroma in the transected group than in the completely dissected group (18.4% vs. 7.2%, p=0.034); there were also significant differences between the two groups in the incidences of seroma at postoperative 7days (18.4% vs. 6.0%, p=0.016) and 1month (14.5% vs. 4.8%, p=0.037). Seroma formation was correlated with age, body mass index, use of anticoagulants, hernia type, hernia size, sac size, and operative time. There were no significant differences between the two groups in the degree of postoperative pain and time taken for the resumption of outdoor activities.ConclusionsWhen using the laparoscopic transabdominal preperitoneal technique for indirect inguinal hernia repair, the risk of postoperative seroma formation is greater after transection compared with complete dissection of the hernial sac.