A Prospective Study On The Effect Of Laparoscopic Treatment Of Residual Hernia Sac In Transabdominal Preperitoneal Inguinal Hernia Repair On Postoperative Seroma

Objectives:To investigate the effect of laparoscopic preperitoneal inguinal hernia repair with the distal sac on postoperative seroma.Methods:Prospective research methods were used.Clinical data of 128 male patients with primary indirect inguinal hernia admitted to Fujian Medical University Union Hospital from October 2017 to March 2019 were selected.Patients were randomly divided into two groups by random number method,The hernia sac was sutured and fixed at the lower margin of the rectus abdominis after transection of the hernia sac,Set as the test group;The patient underwent dissection and transected hernia sac with the residual end free in the abdominal cavity,Set as the control group.Observation indicators:(1)postoperative situation;(2)follow-up situation.Outpatient and telephone follow-up were conducted to understand the incidence of seroma,recurrence,incision infection and chronic pain.The follow-up period ended in June 2019.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was done using the t test.Measurement data with skewed distribution were represented as M(range),and comparison between groups was done using the Mann-Whitney U test.Results:A total of 128 eligible patients were selected,60 cases in the experimental group,68 cases in the control group,The general data of age,body mass index,medical history and basic diseases were compared between the two groups,showing no statistically significant difference between the two groups(P>0.05).(1)Surgical conditions:the operating time of the experimental group and control group was(102+34)min and(97+30)min,showing no statistically significant difference between the two groups(t=0.907,P>0.05).The hospitalization expenses of the experimental group and the control group were(12813+2390)RMB and(12125+2205)RMB,showing no statistically significant difference between the two groups(t=1.685,P>0.05).(2)Follow-up situation:all 128 patients were followed up.There were 8 cases of seratoma in the experimental group and 8 cases in the control group,there was no significant difference between the two groups(x~2=0.072,P>0.05).The extraction volume of patients with seratoma was 20.00m L(4.00 m L,31.25 m L)in the experimental group,and 42.50m L(23.25 m L,97.50 m L)in the control group,the difference between the two groups was statistically significant(Z=-2.013,P<0.05).There was no recurrence,incision infection or chronic pain in the experimental group and control group 3 months after operation.Conclusions:For an indirect inguinal hernia with sac diameter>3 cm,The suture of the posterior stump of the transverse hernia sac to the lower edge of rectus abdominis has a certain advantage,it can reduce the amount of serum extracted after operation.However,our study still needs further validation in more cases and longer follow-up.