| Objectives Compare the clinical effect of local compression of sandbag with that without local sandbag after transabdominal preperitoneal prosthesis and observe whether local compression of sandbag can prevent the formation of serum swelling after TAPP.To further explore the value of local compression of sandbag in preventing serum swelling after TAPP and provide an effective preventive measure of reducing the incidence of seroma after TAPP by evaluating the degree of postoperative seroma,postoperative pain and the change of postoperative comfort.Methods Analysis the clinical data of 97 patients with unilateral inguinal hernia treated by TAPP operation from December 2018 to December 2019 in the Department of Gastrointestinal surgery in Hebei Genaral Hospital.According to whether use compression therapy with 500g sandbag after TAPP or not,and divided 97 inguinal patients into two groups:compression group（group A,n=52）and non-compression group（group B,n=45）.Compare the basic data such as age,BMI,classification of inguinal hernia,history of constipation,hypertension,classification of inguinal hernia,coronary heart disease,diabetes,chronic cough and benign prostatic hyperplasia between the two groups before operation.Collect and record the following dates:1 Check Colour Doppler Ultrasound Examination of Inguinal region after operation and compare the occurrence of seroma and the amount of fluid in the seroma between the two groups on the 7th and 30th day after operation.2 Evaluate the pain of patients between the compression group and the non-compression group at 6thhour,24thhour and on 3rdmonth after operation.3 The comfort of patients between compression group and non-compression group at 6 hours after operation.Set up a database of the collecting clinical case data and postoperative data and import them into Excel and analysis statistic by software SPSS 24.0.Results 1 There was no significant difference by comparing the basic data of hypertension,classification of inguinal hernia and classification of inguinal hernia between the two groups（P>0.05）.2 The incidence of serum swelling of the patients in the compression group and non-compression group on the 7thday after operation was 51.9%vs 62.2%,and 25.0%vs 33.3%after a month and there was no significant difference between the two groups（P>0.05）.the amount of fluid in the seroma of the patients in the compression group and non-compression group on the 7thday after operation was23.43±5.10ml vs 24.28±5.89ml,and 14.28±1.73ml vs 16.16±3.18ml after a month,there was no significant difference between the two groups（P>0.05）.3 The scores of pain of patients in the compression group and the non-compression group at 6thhour,24thhour and3rdmonth after operation were 5.37±1.38 vs 4.49±1.01、2.56±1.21 vs 2.04±0.90、0.50±0.70 vs 0.56±0.50.There was statistical difference by comparing the scores of pain in the two groups at 6thhour and 24thhour after operation in the two groups（P<0.05）.There was no significant difference by comparing the scores of pain in the two groups on the 3rdmonth after operation in the two groups（P>0.05）.4 The percent of the most comfortable was 5.8%vs 22.2%,more comfortable was 60%vs 71%and less comfortable was 34.6%vs 7.1%at the 6thhour after operation between the compression group and the non-compression group,There was statistical difference between the two groups（P<0.05）.Conclusions 1 There was no significant difference in reducing the occurrence of seroma and accelerating its resorption in the compression group compared to the non-compression group.2 Local compression with sandbags may aggravate the patient’s post-operative pain,causing discomfort and interfering with the patient’s ability to get out of bed early.3 In summary,routine sandbag compression after TAPP is not recommended to prevent the formation of postoperative seroma after inguinal hernia.Figure 0;Table 4;Reference 157... |
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