关键词: 老年, 男性, 腹股沟疝, 腹腔镜经腹腹膜前疝修补术, 并发症, 影响因素

Abstract: Objective   To investigate the postoperative complications of laparoscopic transabdominal preperitoneal hernia repair(TAPP) for inguinal hernia in elderly men,and to analyze the related influencing factors.  Methods   A total of 86 elderly male patients with inguinal hernia who underwent laparoscopic TAPP treatment in the hospital from March 2020 to November 2021 were selected,Complications were counted 6 months after the operation,and the patients were divided into a complication group and an uncomplicated group accordingly.The baseline data of the two groups were collected,and the univariate and Logistic multivariate regression analysis of the influencing factors of complications after laparoscopic TAPP for inguinal hernia in elderly men was performed,and a prediction model was established based on the selected independent risk factors.The receiver operating characteristic(ROC) curve was used to observe the predictive value of independent risk factors and predictive models for postoperative complications in patients,and cross-validation was used to test the predictive performance of the predictive models.  Results   Of the 86 patients in this group,76 had no complications,10 had complications,and the complication rate was 11.63%.Univariate analysis showed that the age,body mass index(BMI),the proportion of chronic obstructive pulmonary disease(COPD),and the proportion of hernia sac diameter ≥ 5cm in the complication group were higher than those in the uncomplicated group(P<0.05).Logistic multivariate regression analysis showed that age,BMI,COPD,and diameter of hernia sac were independent risk factors for postoperative complications(P<0.05).Drawing the ROC curve showed that age,BMI,COPD,and hernia sac diameter had good predictive value for postoperative complications,and the areas under the curve(AUC) were 0.757,0.689,0.688,and 0.732,respectively.A prediction model was established based on independent risk factors,The ROC curve showed that the AUC of the prediction model was 0.887,the SE was 0.045,and the 95%CI was 0.799-0.974,P<0.001.Using cross-validation test,it was found that the classification accuracy of the prediction model was 80.23%(69/86).  Conclusion   Elderly men have a higher risk of complications after TAPP for inguinal hernia,and the risk factors include age,BMI,COPD,diameter of hernia sac,The predictive model established on this basis has a good predictive effect on the occurrence of complications,and clinical preventive measures can be taken accordingly.

Key words: elderly, male, inguinal hernia, laparoscopic transabdominal preperitoneal hernia repair, complications, influencing factors