腹腔镜下完全腹膜外疝修补术后未留置引流管的效果评价

目的评价腹腔镜下完全腹膜外疝修补术(TEP)后未留置引流管的临床效果。 方法对苏州大学附属第二医院2010年1月至2016年3月期间住院行TEP治疗的832例腹股沟疝患者的临床资料进行回顾性分析。非引流组537例术后未行术区腹膜外间隙引流，引流组295例术后行术区腹膜前间隙引流，观察两组的术前一般情况及术后治疗效果及并发症的发生情况，评价是否术后留置引流管。 结果对比引流组，非引流组的手术时间[(38.52 ± 16.43)min vs (45.30 ± 15.71) min，P< 0.001]、术后住院时间[(2.84 ± 0.45)d vs (3.36 ± 0.67)d，P< 0.001]、术后恢复工作时间[(4.57 ± 0.43)周 vs (5.84 ± 0.95)周，P< 0.001]、术后疼痛程度(P< 0.05)、术后尿潴留[6.70% vs 10.85%，P＝0.036 9]等明显改善，差异有统计学意义(P< 0.05)，血肿、血清肿[10.99% vs 12.88%，P＝0.4153]等其他术后并发症的发生率，差异无统计学意义(P>0.05)。 结论经回顾性对比研究，腹股沟疝患者在行TEP手术治疗后不放置引流管更有利于术后恢复，且并不增加术后并发症。

Evaluation of non-draining after totally laparoscopic extraperitoneal herniorrhaphy

ObjectiveTo evaluate the feasibility and safety of non-draining after laparoscopic totally extraperitoneal herniorrhaphy (TEP) for inguinal hernia repair. MethodsRetrospective analysis of clinical data of 832 cases of inguinal hernia treated by TEP in the second hospital affiliated to Soochow University from Jan. 2010 to Mar. 2016. A retrospective and comparative analysis was carried on among 537 cases used drainage and 295 cases did not use drainage. We devise the research by analyzing the demography, morbidity parameters, hernia characteristics, hernia level, perioperative and complications of both team, gave a statistical analysis to show the effectiveness of non-use of drainage. ResultsThere are no differences between the two teams in demography, morbidity parameters, hernia characteristics and hernia level (P>0.05). Non-draining team showed a shorter operating time [(38.52 ± 16.43)min vs (45.30 ± 15.71) min, P<0.001], hospital stay after operation [(2.84 ± 0.45)d vs (3.36 ± 0.67)d, P<0.001] and time return to work [(4.57 ± 0.43)weeks vs (5.84 ± 0.95) weeks, P< 0.001], also there were less pain in the non-draining team by measure by the pain score at postoperative 24 h and 1 week (P< 0.05). The complications like seroma [10.99% vs 12.88%, P=0.4153] also had no difference (P<0.05) except uroschesis [6.70% vs 10.85%, P=0.036 9] which happened less in the non-draining team. ConclusionsNo use of drainage after laparoscopic totally extraperitoneal herniorrhaphy is safe, leads to less hospital stay and earlier return to work without cause more complications compares giving a postsurgical drainage.