TAPP斜疝修补术中腹膜前间隙CO₂与血清肿形成的关系：一项前瞻性随机对照研究

Relationship between CO₂ in Preperitoneal Space and Seroma Formation in TAPP Indirect Hernia Repair: A Prospective Randomized Controlled Study

摘要: 目的：探讨腹腔镜经腹腹膜前腹股沟斜疝修补术(TAPP)中腹膜前间隙CO₂与血清肿形成的关系。方法：选取2023年1月至2023年6月于青岛大学附属医院确诊腹股沟斜疝并完成TAPP治疗的101例患者，随机分为试验组(减少腹膜前CO₂残余)和对照组。主要结局是比较术后14天、1个月彩色多普勒超声下的血清肿发生情况。次要结局包括术后疼痛程度，复发，感染等。结果：两组患者的年龄、疝环直径、体质量指数(BMI)、病程等基线人口学特征均无显著性差异(P均 > 0.05)。术后14天试验组血清肿体积、发生率，疼痛程度均明显低于对照组，差异有统计学意义(P均 < 0.05)。术后1个月试验组血清肿发生率和体积，疼痛程度虽低于对照组，但差异无统计学意义(P均 > 0.05)。其余次要结局均无显著性差异(P均 > 0.05)，随访期间两组未出现复发、感染等其他术后并发症。结论：腹腔镜经腹腹膜前腹股沟疝修补术(TAPP)术中减少腹膜前间隙残留CO₂是一种安全有效、操作简便的方法，能显著降低血清肿发生率和体积，减轻术后疼痛。

Abstract: Objective: To explore the relationship between CO₂ in preperitoneal space and seroma formation in laparoscopic preperitoneal inguinal hernia repair (TAPP). Methods: 101 patients with indirect inguinal hernia diagnosed in the Affiliated Hospital of Qingdao University from January 2023 to June 2023 and completed TAPP treatment were randomly divided into an experimental group (reducing the residual CO₂ before peritoneum) and a control group. The main outcome was to compare the incidence of seroma under color Doppler ultrasound 14 days and 1 month after operation. Secondary outcomes included postoperative pain, recurrence and infection. Results: There was no significant difference in baseline demographic characteristics such as age, diameter of hernia ring, body mass index (BMI) and course of disease between the two groups (P > 0.05). Fourteen days after operation, the volume of serum swelling, the incidence rate and the degree of pain in the experimental group were significantly lower than those in the control group, and the difference was statistically significant (P < 0.05). One month after operation, the incidence, volume and pain degree of serum swelling in the experimental group were lower than those in the control group, but the difference was not statistically significant (P > 0.05). There was no significant difference in other secondary outcomes (P > 0.05), and there were no other postoperative complications such as recurrence and infection in the two groups during the follow-up period. Conclusion: Laparoscopic preperitoneal inguinal hernia repair (TAPP) is a safe, effective and simple method to reduce residual CO₂ in preperitoneal space, which can significantly reduce the incidence and volume of seroma and relieve postoperative pain.