ObjectiveTo observe the effect of transabdominal preperitoneal (TAPP) laparoscopic hernia repair by same-day surgery mode for patients with inguinal hernia. MethodsThe patients who underwent TAPP laparoscopic hernia repair were retrospectively collected in the Day Surgery Center of West China Tianfu Hospital from July 2022 to June 2023. All patients in this study were admitted according to the same-day surgery plan, and those who were admitted to the hospital on the same day, operated on the same day, and returned to their homes on the same day, i.e., those who did not stay in the hospital overnight (the same-day surgery plan of the West China Tianfu Hospital of Sichuan University is now basically in the range of 8∶00–20∶00, and the latest discharge is at 21∶00) were classified as the same-day surgery group; however, the patients whose special cases needed to be postponed due to the condition of their illnesses, or those who were discharged from the hospital after 21∶00 due to safety considerations because of other reasons such as postoperative observation of patients with general anesthesia for a period of less than 2–4 h, or those who had a strong desire to be admitted to the hospital overnight, and whose hospital stay was not more than 24 h, were classified as the non-same-day surgery group. The age, gender, marital status, body mass index, hernia type, surgical site, home address, intraoperative bleeding, operative time, total hospitalization cost, pain score at discharge, unplanned revisit rate within 30 d after surgery, discharge satisfaction were compared between the patients of two groups. ResultsA total of 167 patients underwent TAPP laparoscopic hernia repair were enrolled in this study, including 97 in the same-day surgery group and 70 in the non-same-day surgery group. There were no statistically significant differences in the age, gender, marital status, body mass index, hernia type, surgical site, intraoperative bleeding, operative time, and total hospitalization cost between the two groups (P>0.05). However, it was found that the patients in the non-same-day surgery group had a higher pain score at discharge and a higher proportion of home address outside Chengdu city as compared with the same-day surgery group (P=0.042, P<0.001, respectively); The satisfaction rate of all patients in this group was 100% on the 28th day after discharge, and the unplanned revisit rate within 30 d after surgery was 3.6% (6/167), although which in the same-day surgery group was slightly higher than the non-same-day surgery group, the difference was not statistically significant by Fisher test [4.1% (4/97) versus 2.9% (2/70), P=0.226]. ConclusionFrom the analysis results of this study, TAPP laparoscopic hernia repair for patients with inguinal hernia by the same-day surgery mode is safe, and it can further shorten the hospitalization time as compared with the non-same-day surgery.
ObjectiveTo investigate the relation between preoperative peripheral blood neutrophil/albumin (NEU/ALB) or hypersensitive C-reactive protein (hs-CRP)/ALB ratio and seroma after laparoscopic transabdominal preperitoneal (LTAPP) hernia repair. MethodsThe patients diagnosed with inguinal hernia and underwent LTAPP hernia repair admitted to the Heji Hospital Affiliated to Changzhi Medical College from June 2020 to June 2023 were retrospectively collected. The multivariate logistic regression analysis was conducted to identify the risk factors affecting the occurrence of seroma after LTAPP hernia repair. The area under receiver operating characteristic curve (AUC) and 95% confidence interval (95%CI) were used to evaluate the discriminatory value of preoperative peripheral blood NEU/ALB ratio and hs-CRP/ALB ratio for seroma after LTAPP hernia repair. Delong test was used to compare the discriminatory value of these indicators. The test level was α=0.05. ResultsA total of 357 patients who met the inclusion criteria were included in this study, and the seroma occurred in 42 cases (11.8%). The results of multivariate logistic regression analysis showed that the larger the diameter of the hernia sac [OR (95%CI)=4.654 (2.829, 7.657), P<0.001], the more intraoperative bleeding [OR (95%CI)=3.021 (1.498, 6.094), P=0.002], and the higher NEU/ALB ratio [OR (95%CI)=2.585 (1.618, 4.130), P<0.001] or hs-CRP/ALB ratio [OR (95%CI)=1.874 (1.239, 2.834), P=0.003], the higher the probability of seroma after LTAPP hernia repair. The AUC (95%CI) of NEU/ALB or hs-CRP/ALB indicator for predicting seroma after LTAPP hernia repair was 0.750 (0.702, 0.794) and 0.762 (0.715, 0.806), respectively. The optimal cutoff values were 2.970 and 4.001, with sensitivity of 78.6% and 73.8%, and specificity of 60.3% and 65.7%, respectively. The AUC (95%CI) of the NEU/ALB in combination with hs-CRP/ALB in predicting seroma after LTAPP hernia repair was 0.851 (0.810, 0.886), with sensitivity and specificity of 71.4% and 87.0%, respectively. The AUC of the NEU/ALB in combination with hs-CRP/ALB in predicting seroma after LTAPP hernia repair was higher than that of NEU/ALB (Z=2.864, P=0.004) or hs-CRP/ALB alone (Z=2.956, P=0.003). ConclusionFrom the data analysis results of this study, the occurrence rate of seroma after LTAPP hernia repair is not low, and the occurrence of seroma should be paid close attention to patients with larger hernia sac diameter, more intraoperative bleeding, and higher NEU/ALB or hs-CRP/ALB ratio.