腹腔镜腹股沟疝修补术后血清肿预防与应对

目的探讨腹腔镜腹股沟疝修补术后血清肿发生原因、预防和治疗措施。 方法回顾性分析2014年1月至2016年12月，山东大学附属济南市中心医院653侧腹腔镜腹股沟疝修补手术，总结控制血清肿发生的方法。 结果2014至2016年血清肿发生率逐年下降（16.7%比11.8%比9.6%，P<0.05）。Ⅲ型血清肿共4例。Ⅳ型血清肿共9例，其中7例经穿刺抽液后痊愈，2例经穿刺抽液多次无效于术后1年后行鞘膜反转术。1例痊愈，1例术后再次出现积液。 结论可通过提高手术技巧、减少损伤及合理的补片选择降低血清肿发生率。血清肿如不引起患者明显不适，可仅给予观察直至其自行消失，无需主动干预。

Prevention and treatment of seroma after laparoscopic inguinal hernia repair

ObjectiveTo investigate the causes, prevention and treatment of seroma after laparoscopic inguinal hernia repair. MethodsA retrospective analysis was conducted from January 2014 to December 2016 on the 653 side laparoscopic inguinal hernia repair surgery at Jinan Central Hospital Affiliated to Shandong University. Methods for controlling the occurrence of seroma were summarized. ResultsIn 2014-2016, the incidence of seroma decreased year by year (16.7% vs 11.8% vs 9.6%, P<0.05). There were 4 cases of type Ⅲ seroma. A total of 9 cases of type Ⅳ seroma occurred, 7 of them were healed by puncture and aspiration, and 2 cases were ineffective after puncture, and the tunica vaginalis subvolution was performed at 1 year after surgery. One patient recovered and the other one developed effusion again. ConclusionWe can reduce the incidence of seroma by improving surgical techniques, reducing injury, and reasonable mesh selection. If the seroma does not cause significant discomfort to the patient, observation can be given only until it disappears without requiring active intervention.