Effect of hernia defect closure in laparoscopic direct inguinal hernia repair on the prevention of postoperative seroma

doi:10.3877/cma.j.issn.1674-392X.2019.06.019

Abstract

Abstract:

Objective

To investigate the effect of hernia defect suture closure in laparoscopic direct inguinal hernia repair on prevention of postoperative seroma.

Methods

A prospective randomized controlled study was conducted on 200 cases of inguinal hernia in Qinghe County Central Hospital from January 2017 to December 2018. The patients were randomly divided into the experimental group and the control group. Both groups underwent laparoscopic transabdominal preperitoneal hernia repair (TAPP). In the experimental group, hernia ring and sac closure with polyester sutures was performed. The patients in the two groups were reexamined with color Doppler ultrasound in the groin area 7 days, 1 month and 3 months after the operation, to compare the occurrence of seroma in the groin area and to evaluate the serum fluid volume. The operation time, hospitalization time, postoperative chronic pain and recurrence in the two groups were compared.

Results

At 7 d and 1 month after the operation, the color Doppler ultrasound showed that the serum fluid volume in the control group [(30.63±6.86) ml and (20.19±5.94) ml] was significantly higher than those in the experimental group [(15.45±4.16) ml and (11.00±2.23) ml], the differences were statistically significant (P<0.05). At 3 months after the operation, there was no significant difference between the experimental group and the control group in the serum fluid volume [(13.18±5.13) ml vs (10.00±0.00) ml, P>0.05]. The operation time of the experimental group was (53.21±8.21) minutes longer than that of the control group (47.60±5.34) minutes, the difference was statistically significant (P<0.05); the hospitalization time of the experimental group was (3.09±0.55) days was comparable with that of the control group (3.08±0.63) days, the difference was not statistically significant (P>0.05); there was no chronic pain and recurrence in the follow-up period of the two groups.

Conclusion

Defect closure in the laparoscopic direct inguinal hernia repair operation is safe and effective, and it can significantly reduce the incidence of postoperative seroma, without increasing the risk of postoperative infection, pain and recurrence.

Key words: Hernia, inguinal, Laparoscopic, Hernia repair, Seroma

Xiangzhi Zhang, Chuandong Jiao, Zihong Zhang, Yilin Zhu. Effect of hernia defect closure in laparoscopic direct inguinal hernia repair on the prevention of postoperative seroma[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(06): 557-560.

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Figures/Tables 2

References 13

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组别	例数	年龄(岁, ±s)	性别(例)		疝类型(例)		疝环直径(例)		随访时间(个月)
组别	例数	年龄(岁, ±s)	男性	女性	单侧	双侧	>3 cm	≤3 cm	随访时间(个月)
试验组	100	66.64±8.20	100	0	75	25	21	79	3.33
对照组	100	67.09±5.72	100	0	74	26	23	77	3.7
P值	?	0.825	?		0.871		0.773		?

组别	例数	年龄(岁, ±s)	性别(例)		疝类型(例)		疝环直径(例)		随访时间(个月)
组别	例数	年龄(岁, ±s)	男性	女性	单侧	双侧	>3 cm	≤3 cm	随访时间(个月)
试验组	100	66.64±8.20	100	0	75	25	21	79	3.33
对照组	100	67.09±5.72	100	0	74	26	23	77	3.7
P值	?	0.825	?		0.871		0.773		?

组别	例数	血清肿[例(%)]			血清肿积液量(ml, ±s)			手术时间(min, ±s)	术后慢性疼痛(例)	住院时间(d, ±s)	复发(例)
组别	例数	术后7 d	术后1个月	术后3个月	术后7 d	术后1个月	术后3个月	手术时间(min, ±s)	术后慢性疼痛(例)	住院时间(d, ±s)	复发(例)
试验组	100	11(11)	5(5)	1(1)	15.45±4.16	11.00±2.23	10.00±0.00	53.21±8.21	0	3.09±0.55	0
对照组	100	71(71)	52(52)	11(11)	30.63±6.86	20.19±5.94	13.18±5.13	47.60±5.34	0	3.08±0.63	0
P值	?	<0.001	<0.001	0.003	<0.001	0.002	0.490	<0.001	-	0.907	-

组别	例数	血清肿[例(%)]			血清肿积液量(ml, ±s)			手术时间(min, ±s)	术后慢性疼痛(例)	住院时间(d, ±s)	复发(例)
组别	例数	术后7 d	术后1个月	术后3个月	术后7 d	术后1个月	术后3个月	手术时间(min, ±s)	术后慢性疼痛(例)	住院时间(d, ±s)	复发(例)
试验组	100	11(11)	5(5)	1(1)	15.45±4.16	11.00±2.23	10.00±0.00	53.21±8.21	0	3.09±0.55	0
对照组	100	71(71)	52(52)	11(11)	30.63±6.86	20.19±5.94	13.18±5.13	47.60±5.34	0	3.08±0.63	0
P值	?	<0.001	<0.001	0.003	<0.001	0.002	0.490	<0.001	-	0.907	-

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