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中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 6 -9. doi: 10.3877/cma.j.issn.1674-392X.2019.01.003

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腹腔镜腹股沟疝修补术后浆液肿的预防措施
李俊生1,(), 邵翔宇1, 程韬1, 嵇振岭1   
  1. 1. 210009 南京,东南大学附属中大医院普外科
  • 收稿日期:2018-10-10 出版日期:2019-02-18
  • 通信作者: 李俊生

Preventive managemengt for postoperative seroma after laparoscopic inguinal hernia repair

Junsheng Li1,(), Xiangyu Shao1, Tao Cheng1, Zhenling Ji1   

  1. 1. Department of General Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China
  • Received:2018-10-10 Published:2019-02-18
  • Corresponding author: Junsheng Li
  • About author:
    Corresponding author: Li Junsheng, Email:
引用本文:

李俊生, 邵翔宇, 程韬, 嵇振岭. 腹腔镜腹股沟疝修补术后浆液肿的预防措施[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(01): 6-9.

Junsheng Li, Xiangyu Shao, Tao Cheng, Zhenling Ji. Preventive managemengt for postoperative seroma after laparoscopic inguinal hernia repair[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(01): 6-9.

腹腔镜腹股沟疝修补术后的浆液肿发生率较高,浆液肿是腹腔镜腹股沟疝修补术后常见的现象。关于如何预防腹腔镜疝术后浆液肿的发生,尚无一致意见。本文阐述了腹腔镜疝术后浆液肿发生的机理,易发因素及预防措施,并介绍了我们在这方面的临床经验。腹股沟直疝及大的斜疝或者阴囊疝术后浆液肿发生率较高。对于腹股沟直疝,可以在腹腔镜疝直疝修补术时将疝囊关闭(采用倒刺缝线或者endoloop)值得推荐,对于较大的腹股沟斜疝,可以尝试采用倒刺缝线悬吊远端疝囊,对于某些特殊情况,可以选择性放置引流管,早期拔出引流。

The seroma is a common complication after laparoscopic inguinal hernia repair. There is no consistent opinion on how to prevent the occurrence of seroma after laparoscopic hernia surgery. This article describes the mechanism, risk factors and preventive management of postoperative seroma following laparoscopic hernia repair, and introduces our clinical experience in this field. The incidence of seroma in the direct inguinal hernia and the large indirect or scrotal hernia is high. For the direct inguinal hernias, it is recommended to close the hernia sac during laparoscopic hernia repair (with barbed suture or endoloop). For large indirect inguinal hernias, it can be performed with distal sac hung with a barbed suture. For some special cases, it can selectively place the drainage tube and pull out the drainage at an early stage.

图1 采用倒刺线沿着直疝缺损边缘缝合腹横筋膜环周3~4针
图2 应用倒刺线贯穿缝合拉出的腹横筋膜底部
图3 拉紧倒刺缝线,关闭直疝缺损,必要时增加缝合固定
图4 离断阴囊疝的疝囊,拉住远端疝囊的下瓣腹膜
图5 采用倒刺线将离断的疝囊远端下瓣缝合到前腹壁悬吊,1~2针
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