Abstract：
OBJECTIVE: Seroma formation is the most common cause of morbidity associated with laparoscopic inguinal hernia repair. This study aimed to examine the relationship between the thickness of subcutaneous fat (TSF) and the risk of postoperative seroma.
METHODS: We reviewed data from a prospective cohort of 229 male patients who underwent laparoscopic total extra-peritoneal (TEP) hernioplasty for indirect inguinal hernia between August 2018 and July 2021. The TSF was assessed using preoperative ultrasound images. The risk factors for postoperative seroma were determined using univariate and multivariate logistic regression models.
RESULTS: Postoperative seromas occurred in 26 patients (11.4%). The factors associated with postoperative seroma included longer hernia duration, larger hernia defects, extension into the scrotum, and greater TSF (P < 0.05). In multivariate analysis, a greater TSF was independently associated with a greater risk of postoperative seroma (per 1 mm: odd ratio [OR] 1.105, 95% confidence interval [CI] 1.048-1.165, P < 0.001; TSF ≥ 26.0 mm: OR 7.033, 95% CI 2.485-19.901, P < 0.001). Similar results were obtained in the subgroup analysis. The area under the curve of TSF for predicting seroma formation was 0.703 (95% CI 0.601-0.806).
CONCLUSIONS: Ultrasound-derived TSF may be a promising prognostic factor for postoperative seroma in patients undergoing laparoscopic TEP repair. Further validation is required and then this parameter can be used to improve decision-making process.
METHODS: We reviewed data from a prospective cohort of 229 male patients who underwent laparoscopic total extra-peritoneal (TEP) hernioplasty for indirect inguinal hernia between August 2018 and July 2021. The TSF was assessed using preoperative ultrasound images. The risk factors for postoperative seroma were determined using univariate and multivariate logistic regression models.
RESULTS: Postoperative seromas occurred in 26 patients (11.4%). The factors associated with postoperative seroma included longer hernia duration, larger hernia defects, extension into the scrotum, and greater TSF (P < 0.05). In multivariate analysis, a greater TSF was independently associated with a greater risk of postoperative seroma (per 1 mm: odd ratio [OR] 1.105, 95% confidence interval [CI] 1.048-1.165, P < 0.001; TSF ≥ 26.0 mm: OR 7.033, 95% CI 2.485-19.901, P < 0.001). Similar results were obtained in the subgroup analysis. The area under the curve of TSF for predicting seroma formation was 0.703 (95% CI 0.601-0.806).
CONCLUSIONS: Ultrasound-derived TSF may be a promising prognostic factor for postoperative seroma in patients undergoing laparoscopic TEP repair. Further validation is required and then this parameter can be used to improve decision-making process.
摘要：
目的：血清瘤形成是腹腔镜腹股沟疝修补术相关发病的最常见原因。本研究旨在研究皮下脂肪厚度（TSF）与术后血清肿风险之间的关系。
方法：我们回顾了在2018年8月至2021年7月期间接受腹腔镜全腹膜外（TEP）疝修补术治疗腹股沟斜疝的229例男性患者的前瞻性队列数据。使用术前超声图像评估TSF。使用单变量和多变量逻辑回归模型确定术后血清肿的危险因素。
结果：26例（11.4%）患者发生术后血清瘤。与术后血清肿相关的因素包括较长的疝持续时间，较大的疝缺损,延伸到阴囊，TSF越大(P<0.05)。在多变量分析中，TSF越大,术后血清肿风险越大(每1mm:奇数比[OR]1.105,95%置信区间[CI]1.048-1.165,P<0.001;TSF≥26.0mm:OR7.033,95%CI2.485-19.901,P<0.001).在亚组分析中获得了类似的结果。TSF预测血清肿形成的曲线下面积为0.703（95％CI0.601-0.806）。
结论：超声来源的TSF可能是腹腔镜TEP修补术患者术后血清肿的一个有希望的预后因素。需要进一步验证，然后可以使用此参数来改善决策过程。
方法：我们回顾了在2018年8月至2021年7月期间接受腹腔镜全腹膜外（TEP）疝修补术治疗腹股沟斜疝的229例男性患者的前瞻性队列数据。使用术前超声图像评估TSF。使用单变量和多变量逻辑回归模型确定术后血清肿的危险因素。
结果：26例（11.4%）患者发生术后血清瘤。与术后血清肿相关的因素包括较长的疝持续时间，较大的疝缺损,延伸到阴囊，TSF越大(P<0.05)。在多变量分析中，TSF越大,术后血清肿风险越大(每1mm:奇数比[OR]1.105,95%置信区间[CI]1.048-1.165,P<0.001;TSF≥26.0mm:OR7.033,95%CI2.485-19.901,P<0.001).在亚组分析中获得了类似的结果。TSF预测血清肿形成的曲线下面积为0.703（95％CI0.601-0.806）。
结论：超声来源的TSF可能是腹腔镜TEP修补术患者术后血清肿的一个有希望的预后因素。需要进一步验证，然后可以使用此参数来改善决策过程。
