PDF(Pubmed)
Abstract：
BACKGROUND: The value of prophylactic closed-suction drainage in totally extraperitoneal inguinal hernia repair (TEP) is still a matter of controversy. We conducted a meta-analysis of studies examining postoperative seroma rates in patients with or without routine placement of closed-suction drainage tubes.
METHODS: A systematic literature search was conducted for trials comparing the outcome of TEP with or without routine drainage placement. Data regarding postoperative outcomes were extracted and compared by meta-analysis. The odds ratio and standardized mean differences with 95% confidence intervals were calculated.
RESULTS: Four studies were identified, involving a total of 1626 cases (Drain: n = 1251, no Drain: n = 375). There was a statistically significant difference noted between the 2 groups regarding postoperative seroma formation favoring the Drain group (odds ratio = 0.12; 95% confidence intervals [0.05, 0.29]; P < .001; 4 studies; I2 = 72%). For the remaining secondary endpoints postoperative urinary retention, recurrence, mesh infection and in-hospital length of stay no statistically significant difference was noted between the 2 study groups.
CONCLUSIONS: Current evidence suggests that patients who underwent TEP with routine closed-suction drain placement developed significantly fewer seromas without any additional morbidity or prolongation of in-hospital stay.
METHODS: A systematic literature search was conducted for trials comparing the outcome of TEP with or without routine drainage placement. Data regarding postoperative outcomes were extracted and compared by meta-analysis. The odds ratio and standardized mean differences with 95% confidence intervals were calculated.
RESULTS: Four studies were identified, involving a total of 1626 cases (Drain: n = 1251, no Drain: n = 375). There was a statistically significant difference noted between the 2 groups regarding postoperative seroma formation favoring the Drain group (odds ratio = 0.12; 95% confidence intervals [0.05, 0.29]; P < .001; 4 studies; I2 = 72%). For the remaining secondary endpoints postoperative urinary retention, recurrence, mesh infection and in-hospital length of stay no statistically significant difference was noted between the 2 study groups.
CONCLUSIONS: Current evidence suggests that patients who underwent TEP with routine closed-suction drain placement developed significantly fewer seromas without any additional morbidity or prolongation of in-hospital stay.
摘要：
背景：预防性封闭式吸引引流在完全腹膜外腹股沟疝修补术（TEP）中的价值仍然存在争议。我们对有或没有常规放置闭式引流管的患者的术后血清肿发生率进行了荟萃分析。
方法：进行了系统的文献检索，以比较有或没有常规引流的TEP结果。提取有关术后结果的数据，并通过荟萃分析进行比较。计算比值比和95%置信区间的标准化平均差。
结果：确定了四项研究，共1626例（排水：n=1251，无排水：n=375）。在术后血清肿形成方面，两组之间存在统计学上的显着差异，有利于Drain组（比值比=0.12;95％置信区间[0.05，0.29];P<.001;4项研究;I2=72％）。对于术后尿潴留的其余次要终点，复发,2个研究组间网片感染和住院时间无统计学差异.
结论：目前的证据表明，行TEP并进行常规闭式引流的患者出现的血清瘤明显减少，没有任何额外的发病率或住院时间延长。
方法：进行了系统的文献检索，以比较有或没有常规引流的TEP结果。提取有关术后结果的数据，并通过荟萃分析进行比较。计算比值比和95%置信区间的标准化平均差。
结果：确定了四项研究，共1626例（排水：n=1251，无排水：n=375）。在术后血清肿形成方面，两组之间存在统计学上的显着差异，有利于Drain组（比值比=0.12;95％置信区间[0.05，0.29];P<.001;4项研究;I2=72％）。对于术后尿潴留的其余次要终点，复发,2个研究组间网片感染和住院时间无统计学差异.
结论：目前的证据表明，行TEP并进行常规闭式引流的患者出现的血清瘤明显减少，没有任何额外的发病率或住院时间延长。
