Abstract：
OBJECTIVE: Seroma represents the most prevalent postoperative complication following laparoscopic inguinal hernia repair, particularly in the case of large inguinoscrotal hernias. This randomized controlled trial was undertaken with the objective of assessing the effects of internal orifice narrowing achieved by suturing the divided distal hernia sac in laparoscopic repair of indirect inguinoscrotal hernias.
METHODS: A total of 58 patients aged 18 years or older, were randomized into two groups: Group I, which underwent internal orifice narrowing, and Group II, which served as the control without narrowing. The study\'s primary endpoint was the incidence and volume of seroma in the inguinal region on postoperative days 1 and 7, as well as at 1, 3, and 6 months following the procedure. Secondary outcomes encompassed metrics like total operative time, acute and chronic pain levels, duration of hospital stay, recurrence rates, and the occurrence of any additional complications.
RESULTS: In comparison to the control group, the experimental group exhibited a significantly lower incidence of seroma formation at 7 days (P = 0.001). Furthermore, the ultrasonic assessment indicated a reduced seroma volume in the operative group on postoperative day 7 (8.84 ± 17.71 vs. 52.39 ± 70.78 mL; P < 0.001). Acute pain levels and hospital stay were similar between the two groups (1.22 ± 0.76 vs. 1.04 ± 0.53, P = 0.073; 1.22 ± 0.07 vs. 1.19 ± 0.08, P = 0.627, respectively). Notably, neither chronic pain nor early recurrence, nor any other postoperative complications were observed in either group throughout the follow-up period, which extended for at least 6 months (range: 6-18 months).
CONCLUSIONS: In the context of laparoscopic inguinoscrotal hernia repair, the incidence and volume of seroma can be significantly reduced through the implementation of internal orifice narrowing achieved by suturing the divided distal hernia sac. And, this reduction in seroma formation was not associated elevation in postoperative pain levels or recurrence rates.
METHODS: A total of 58 patients aged 18 years or older, were randomized into two groups: Group I, which underwent internal orifice narrowing, and Group II, which served as the control without narrowing. The study\'s primary endpoint was the incidence and volume of seroma in the inguinal region on postoperative days 1 and 7, as well as at 1, 3, and 6 months following the procedure. Secondary outcomes encompassed metrics like total operative time, acute and chronic pain levels, duration of hospital stay, recurrence rates, and the occurrence of any additional complications.
RESULTS: In comparison to the control group, the experimental group exhibited a significantly lower incidence of seroma formation at 7 days (P = 0.001). Furthermore, the ultrasonic assessment indicated a reduced seroma volume in the operative group on postoperative day 7 (8.84 ± 17.71 vs. 52.39 ± 70.78 mL; P < 0.001). Acute pain levels and hospital stay were similar between the two groups (1.22 ± 0.76 vs. 1.04 ± 0.53, P = 0.073; 1.22 ± 0.07 vs. 1.19 ± 0.08, P = 0.627, respectively). Notably, neither chronic pain nor early recurrence, nor any other postoperative complications were observed in either group throughout the follow-up period, which extended for at least 6 months (range: 6-18 months).
CONCLUSIONS: In the context of laparoscopic inguinoscrotal hernia repair, the incidence and volume of seroma can be significantly reduced through the implementation of internal orifice narrowing achieved by suturing the divided distal hernia sac. And, this reduction in seroma formation was not associated elevation in postoperative pain levels or recurrence rates.
摘要：
目的：血清肿是腹腔镜腹股沟疝修补术后最常见的术后并发症，特别是在大腹股沟阴囊疝的情况下。进行这项随机对照试验的目的是评估通过缝合分开的远端疝囊在腹腔镜间接腹股沟腹疝修补术中实现的内孔狭窄的效果。
方法：共58名年龄在18岁或以上的患者，随机分为两组：第一组，经历了内部孔口变窄，第二组，作为没有缩小的控制。该研究的主要终点是术后第1天和第7天以及术后1、3和6个月时腹股沟区血清肿的发生率和体积。次要结果包括总手术时间等指标，急性和慢性疼痛水平，住院时间,复发率,以及任何其他并发症的发生。
结果：与对照组相比，实验组在第7天血清肿形成的发生率显著降低(P=0.001).此外，超声评估显示手术组术后第7天血清肿体积减少（8.84±17.71vs.52.39±70.78mL；P<0.001）。两组的急性疼痛程度和住院时间相似（1.22±0.76vs.1.04±0.53，P=0.073；1.22±0.07vs.分别为1.19±0.08，P=0.627）。值得注意的是,既不是慢性疼痛也不是早期复发，在整个随访期间，两组均未观察到任何其他术后并发症，延长至少6个月（范围：6-18个月）。
结论：在腹腔镜腹股沟阴囊疝修补术中，通过缝合分开的远端疝囊实现内孔狭窄，可以显着降低血清肿的发生率和体积。And,血清肿形成的减少与术后疼痛水平或复发率的升高无关.
方法：共58名年龄在18岁或以上的患者，随机分为两组：第一组，经历了内部孔口变窄，第二组，作为没有缩小的控制。该研究的主要终点是术后第1天和第7天以及术后1、3和6个月时腹股沟区血清肿的发生率和体积。次要结果包括总手术时间等指标，急性和慢性疼痛水平，住院时间,复发率,以及任何其他并发症的发生。
结果：与对照组相比，实验组在第7天血清肿形成的发生率显著降低(P=0.001).此外，超声评估显示手术组术后第7天血清肿体积减少（8.84±17.71vs.52.39±70.78mL；P<0.001）。两组的急性疼痛程度和住院时间相似（1.22±0.76vs.1.04±0.53，P=0.073；1.22±0.07vs.分别为1.19±0.08，P=0.627）。值得注意的是,既不是慢性疼痛也不是早期复发，在整个随访期间，两组均未观察到任何其他术后并发症，延长至少6个月（范围：6-18个月）。
结论：在腹腔镜腹股沟阴囊疝修补术中，通过缝合分开的远端疝囊实现内孔狭窄，可以显着降低血清肿的发生率和体积。And,血清肿形成的减少与术后疼痛水平或复发率的升高无关.
