腹腔镜腹股沟疝修补术后浆液肿的预防措施

摘要

腹腔镜腹股沟疝修补术后的浆液肿发生率较高,浆液肿是腹腔镜腹股沟疝修补术后常见的现象.关于如何预防腹腔镜疝术后浆液肿的发生,尚无一致意见.本文阐述了腹腔镜疝术后浆液肿发生的机理,易发因素及预防措施,并介绍了我们在这方面的临床经验.腹股沟直疝及大的斜疝或者阴囊疝术后浆液肿发生率较高.对于腹股沟直疝,可以在腹腔镜疝直疝修补术时将疝囊关闭(采用倒刺缝线或者endoloop)值得推荐,对于较大的腹股沟斜疝,可以尝试采用倒刺缝线悬吊远端疝囊,对于某些特殊情况,可以选择性放置引流管,早期拔出引流.%The seroma is a common complication after laparoscopic inguinal hernia repair.There is no consistent opinion on how to prevent the occurrence of seroma after laparoscopic hernia surgery.This article describes the mechanism,risk factors and preventive management of postoperative seroma following laparoscopic hernia repair,and introduces our clinical experience in this field.The incidence of seroma in the direct inguinal hernia and the large indirect or scrotal hernia is high.For the direct inguinal hernias,it is recommended to close the hernia sac during laparoscopic hernia repair (with barbed suture or endoloop).For large indirect inguinal hernias,it can be performed with distal sac hung with a barbed suture.For some special cases,it can selectively place the drainage tube and pull out the drainage at an early stage.