摘要目的:探讨常规器械单孔腹腔镜经腹腹膜前修补术（TAPP）治疗腹股沟疝的临床价值及术后发生血清肿的影响因素。方法:采用回顾性队列研究方法。收集2020年3月至2025年3月南通大学附属医院收治的1 427例腹股沟疝患者的临床资料；男1 260例，女167例；年龄为（63±11）岁。所有患者行常规器械单孔腹腔镜TAPP。观察指标：（1）手术情况。（2）术后情况。（3）随访情况。（4）影响常规器械单孔腹腔镜TAPP后发生血清肿的因素分析。正态分布的计量资料组间比较采用独立样本 t检验；偏态分布的计量资料组间比较采用Mann-Whitney U检验。计数资料以绝对数表示，组间比较采用 χ2检验。单因素分析根据指标类型采用对应的统计学方法，多因素分析采用Logistic回归模型。 结果:（1）手术情况：1 427例患者中，1 406例顺利完成手术，21例中转3孔手术，无中转开放手术患者。1 346例单侧疝手术时间为（22±9）min，81例双侧疝手术时间为（41±13）min。1 427例患者术中出血量为（6.5±1.8）mL。1 427例患者中，术中穿刺器导致血管损伤5例，神经损伤2例，无术中邻近器官损伤患者。（2）术后情况：1 427例患者术后首次下床活动时间为（6.5±2.2）h，术后住院时间为1（1，2）d，总住院费用为（16 250±1 480）元。1 427例患者中，术后发生疼痛91例［术后24 h视觉模拟量表评分为2（1，3）分］、尿潴留69例、切口感染3例。无补片感染患者。（3）随访情况：1 427例患者均获得1年以上随访，随访时间为38（24，52）个月，随访期间出现慢性疼痛46例、血清肿283例，复发1例，无粘连性肠梗阻及穿刺孔疝患者。1 427例患者手术美容评分为（9.97±0.24）分。（4）影响常规器械单孔腹腔镜TAPP后发生血清肿的因素分析：多因素分析结果示体质量指数（BMI）>28 kg/m 2、术前白蛋白<30 g/L、复发疝、病程>3年、长期服用抗凝药物、疝环长径>3 cm均是患者术后发生血清肿的独立危险因素（比值比=1.63、2.18、2.14、1.64、1.72、1.39，95%可信区间为1.09~2.44、1.07~4.45、1.21~3.78、1.22~2.20、1.15~2.57、1.02~1.90， P<0.05）。 结论:常规器械单孔腹腔镜TAPP治疗腹股沟疝安全、可行，手术美容效果好。BMI>28 kg/m 2、术前白蛋白<30 g/L、复发疝、病程>3年、长期服用抗凝药物、疝环长径>3 cm均是患者术后发生血清肿的独立危险因素。

abstractsObjective:To investigate the clinical value of conventional instrument single-port laparoscopic transabdominal preperitoneal prosthesis (TAPP) for inguinal hernia and the influen-cing factors of postoperative seroma.Methods:The retrospective cohort study was conducted. The clinical data of 1 427 patients with inguinal hernia who were admitted to Affiliated Hospital of Nantong University from March 2020 to March 2025 were collected. There were 1 260 males and 167 females, aged (63±11) years. All patients underwent conventional instrument single-port laparo-scopic TAPP. Observation indicators: (1) surgical conditions; (2) postoperative conditions; (3) follow-up; (4) analysis of influencing factors for seroma after conventional instrument single-port laparos-copic TAPP.Comparison of measurement data with normal distribution was conducted using the inde-pendent sample t test, comparison of measurement data with skewed distribution was conducted using the Mann-Whitney U test. Comparison of count data was conducted using the chi-square test. Univariate analysis was conducted using corresponding statistical methods based on the type of indicators, and multivariate analysis was performed using the Logistic regression model. Results:(1) Surgical conditions: of the 1 427 patients, 1 406 cases completed the surgery successfully, 21 cases were converted to three-port surgery, and no patient was converted to open surgery. The operation time was (22±9) minutes of 1 346 patients with unilateral hernia, and (41±13) minutes of 81 patients with bilateral hernia. The volume of intraoperative blood loss of the 1 427 patients was (6.5±1.8) mL. Of 1 427 patients, 5 cases had vascular injury due to intraoperative trocar insertion, 2 cases had neuronal injury, and no patient had intraoperative adjacent organ injury. (2) Postoperative condi-tions: the first ambulation time of the 1 427 patients was (6.5±2.2) hours, duration of postoperative hospital stay was 1(1,2) days, total hospitalization cost was (16 250±1 480) yuan. Postoperative pain occurred in 91 cases with visual analog scale score as 2(1,3) at 24 h postoperatively, urinary retention in 69 cases, wound infection in 3 cases. There was no mesh infection.(3) Follow-up: all the 1 427 patients were followed up for at least 1 year, with the follow-up time of 38 (24,52) months. During the follow-up, chronic pain occurred in 46 cases, seroma in 283 cases, hernia recurrence in 1 case, and no adhesive intestinal obstruction or trocar site hernia was observed. The aesthetic surgical score of 1 427 patients was 9.97±0.24. (4) Analysis of influencing factors for seroma after conventional instrument single-port TAPP: results of multivariate analysis showed that body mass index (BMI) >28 kg/m2, preoperative albumin <30 g/L, hernia recurrence, disease duration >3 years, long-term anticoagulant use, and hernia ring diameter >3 cm were independent risk factors for postoperative seroma ( odds ratio=1.63, 2.18, 2.14, 1.64, 1.72, 1.39, 95% confidence interval as 1.09-2.44, 1.07-4.45, 1.21-3.78, 1.22-2.20, 1.15-2.57, 1.02-1.90, P<0.05). Conclusions:Conventional instrument single-port laparoscopic TAPP is safe and feasible for inguinal hernia with good cosmetic outcomes. BMI >28 kg/m2, preoperative albumin <30 g/L, hernia recurrence, disease duration > 3 years, long-term anticoagulant use, and hernia ring diameter > 3 cm are independent risk factors for postoperative seroma.