腹腔镜下腹股沟疝修补术中腹膜前放置引流管减轻血清肿形成的Meta分析  

Anterior Peritoneal Drainage Tube Placement during Laparoscopic Inguinal Hernia Repair Reduces Seroma Formation:a Meta-Analysis

作　　者：韩曲 曾慧[1] 汪艮亮 徐维 HAN Qu;ZENG Hui;WANG Gen-liang;XU Wei(Department of General Surgery,Fengcheng People’s Hospital,Fengcheng 331104,China;Colorectal Cancer Treatment Center,the 2 nd Affiliated Hospital,Jiangxi Medical College,Nanchang University,Nanchang 330006,China)

机构地区：[1]丰城市人民医院普外一科,江西丰城331104 [2]南昌大学第二附属医院结直肠肿瘤诊疗中心,南昌330006

出　　处：《南昌大学学报（医学版）》2023年第6期27-32,38,共7页Journal of Nanchang University：Medical Sciences

基　　金：国家自然科学基金(81860435)。

摘　　要：目的系统评价腹腔镜下腹股沟疝修补术中腹膜前放置引流管的临床疗效。方法检索PubMed、Embase、Cochrane Library、Web of Science、万方、中国生物医学文献服务系统、中国知网、维普等数据库,收集腹腔镜下经腹膜前腹股沟疝修补术(TAPP)或完全腹膜外腹股沟疝修补术(TEP)中腹膜前放置引流管减少血清肿形成的相关研究文献,检索时间为2000年9月至2022年9月,由2名研究人员严格按照纳入/排除标准独立完成文献筛选、资料提取及质量评价等,采用RevMan 5.3软件进行Meta分析。结果共纳入9篇文献,1944例患者。Meta分析显示:观察组(腹膜前放置引流管)术后血清肿形成率显著低于对照组(腹膜前未放置引流管)(P<0.00001,I~2=42%);TAPP(P<0.0001,I~2=0%)或TEP(P<0.00001,I~2=0%)中观察组较对照组术后血清肿形成率均更低。观察组手术时间较对照组更长(P<0.00001,I~2=17%)。2组术中出血量、术后24 h及1周疼痛评分比较差异均无统计学意义(P>0.05,I~2=0%)。结论腹腔镜下腹股沟疝修补术中腹膜前放置引流管能有效降低患者术后血清肿的形成率,且具有较好的安全性。Objective To systematically evaluate the clinical efficacy of anterior peritoneal drainage tube placement in laparoscopic inguinal hernia repair.Methods We searched PubMed,Embase,Cochrane Library,Wanfang,China Biomedical Literature Service System,CNKI,VIP and other databases to collect the relevant research literature regarding the clinical efficacies of anterior peritoneal drainage tube placement during laparoscopic transperitoneal inguinal hernia repair(TAPP) or totally extraperitoneal inguinal hernia repair(TEP) for reducing seroma formation from September 2000 to September 2022.Two researchers independently completed literature screening,data extraction and quality evaluation in strict accordance with the inclusion/exclusion criteria.The meta-analysis was performed using RevMan 5.3 software.Results A total of 9 articles involving 1944 patients were included.The meta-analysis showed that the seroma formation rates after operation,during TAPP and during TEP in the observation group(patients received preperitoneal drainage tube placement) were significantly lower than that in the control group(patients did not receive preperitoneal drainage tube placement)(P<0.000 01,I~2=42%,0% and 0%,respectively).The operation time in the observation group was longer than that in the control group(P< 0.000 01,I~2=17%).There were no statistically significant differences in intraoperative blood loss and 24-hour and 1-week postoperative pain scores between the two groups(P>0.05,I~2=0%).Conclusion Anterior peritoneal drainage tube placement during laparoscopic inguinal hernia repair can effectively and safely reduce postoperative seroma formation.

关 键 词：腹腔镜下完全腹膜外疝修补术 腹腔镜下经腹膜前疝修补术 引流 血清肿 META分析 

分 类 号：R656.21[医药卫生—外科学]