Large Symptomatic Inguinoscrotal Seroma Occurred Early after Laparoscopic Total Extraperitoneal Hernia Repair (TEP): a Case Report and Literature Review.
Claudiu-Octavian Ungureanu, Floris Stanculea, Octav Ginghina, Cosmin Ene, Andrei Stoica, Bogdan Geavlete, Daniel Alin Cristian, Valentin Titus Grigorean, Petrisor Geavlete, Niculae Iordache
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引用次数: 0
Abstract
Inguinoscrotal hernia (ISH) is an entity for which treatment is under debate. Open surgery is the standard approach, but the laparoscopic technique has a great outcome when used by experienced surgeons. Seroma is one of the complications following laparoscopic hernia repair for these scrotal hernias, which is due to the large hernia sac, usually transected, leaving in place a remnant of the sac. Conservative measures can be applied for the treatment of seroma; however, in symptomatic cases, puncture and aspiration of fluid are recommended. Sometimes, these seromas can reach a large size and require surgery to remove the remnant sac. Herein, we report the case of a 49-year-old male with a large seroma that occurred four days after the laparoscopic approach - total extraperitoneal repair (TEP) for inguinoscrotal hernia. Conservative measures failed, and because the symptoms were not alleviated, reintervention was opted for. The distal sac was excised and the patient recovered uneventfully. The six-month follow-up did not show any recurrence of the hernia or seroma. We emphasize the importance of sac management in large ISH cases and discuss seromas after laparoscopic hernia repair in such instances.
阴茎腹股沟疝(ISH)是一种实体疝,其治疗方法尚存在争议。开腹手术是标准方法,但如果由经验丰富的外科医生使用腹腔镜技术,则会取得很好的疗效。血清肿是阴囊疝腹腔镜疝修补术后的并发症之一,其原因是疝囊较大,通常被横切,留下残余的疝囊。血清肿的治疗可采用保守疗法,但对于有症状的病例,建议进行穿刺和抽液。有时,这些血清肿会变得很大,需要手术切除残余的囊。在此,我们报告了一例 49 岁男性患者的病例,他在采用腹腔镜方法--全腹膜外修补术(TEP)治疗腹股沟疝四天后出现大血清肿。保守治疗无效,由于症状没有得到缓解,患者选择了再次手术。切除了远端囊肿,患者恢复顺利。六个月的随访未发现疝气或血清肿复发。我们强调了在大型 ISH 病例中囊处理的重要性,并讨论了在这种情况下腹腔镜疝修补术后血清肿的问题。