Investigation of risk factors for postoperative seroma/hematoma after TAPP

Morito, Atsushi; Kosumi, Keisuke; Kubota, Tatsuo; Yumoto, Shinsei; Matsumoto, Takashi; Mima, Kosuke; Inoue, Mitsuhiro; Mizumoto, Takao; Miyanari, Nobutomo; Baba, Hideo

doi:10.1007/s00464-021-08814-2

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…Given its adverse effects, investigating potential risk factors and implementing preventative measures is crucial for improving prognosis. The overall incidence of seroma in this study was 11.3%, as determined by physical examinations combined with ultrasound, which is consistent with the reported rate of 12.6% by Ruze et al 14 and lower than the rate of 19.2% reported by Morito et al 4 …”

Section: Discussionsupporting

confidence: 92%

“… 1 Therefore, it is imperative to conduct extensive research on the factors contributing to the development of postoperative seroma. According to a recent study conducted by Atsushi et al, 4 it was found that two risk factors significantly contribute to the formation of postoperative seroma/hematoma: hernia size ≥ 3 cm and internal inguinal hernia. Despite extensive research on the subject, there is currently no consensus regarding the specific risk factors associated with the development of postoperative seroma.…”

Section: Introductionmentioning

confidence: 99%

“… 2 , 3 Because of the advantages of small wounds and allowing visual inspection of both inguinal regions, laparoscopic repair constitutes a large proportion of inguinal hernia surgeries. 4 Transabdominal preperitoneal Patch Plasty (TAPP) is a very commonly used surgical method for inguinal hernia repair. 5 …”

Section: Introductionmentioning

confidence: 99%

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Modified Frailty Index and Albumin-Fibrinogen Ratio Predicts Postoperative Seroma After Laparoscopic TAPP

Zhou,

Ge,

Liu

et al. 2023

CIA

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Background Postoperative seroma is the most common minor complication after inguinal hernia repair surgery and can have negative consequences. The objective of this study was to identify potential risk factors for postoperative seroma. Methods This study consecutively included 354 elderly patients with inguinal hernia who underwent laparoscopic Transabdominal preperitoneal Patch Plasty (TAPP). Seroma diagnosis was conducted by the same experienced surgeon based on the physical examinations combined with ultrasound. Risk factors for seroma were identified through univariate analysis and subsequently included in the binary multivariate logistic regression model. Results A total of 40 patients experienced postoperative complications of seroma, with an incidence rate of 11.3% (40/354). The binary logistic regression analysis revealed that obesity (OR: 2.98, 95% CI: 1.20–7.41, P = 0.018), disease duration ≥ 4.5 years (OR: 4.88, 95% CI: 2.14–11.18, P < 0.001), albumin-fibrinogen ratio (AFR) level < 9.25 (OR: 6.13, 95% CI: 2.00–18.76, P = 0.001), and modified frailty index (mFI) score ≥ 0.225 (OR: 6.38, 95% CI: 2.69–15.10, P < 0.001) were four independent risk factors for postoperative seroma. Conclusion Obesity, prolonged disease duration, decreased AFR level, and increased mFI score independently predict postoperative seroma after laparoscopic TAPP.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Modified Frailty Index and Albumin-Fibrinogen Ratio Predicts Postoperative Seroma After Laparoscopic TAPP

Zhou,

Ge,

Liu

et al. 2023

CIA

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“…Many risk factors have been identified in the development of seroma. It has been reported that hernias descending into the scrotum, transection of the distal hernia sac, large hernia defect diameter, direct hernias, high ASA score, strangulated hernia, direct hernia, advanced age, and the use of different mesh fixation techniques increased the risk of seroma formation 1,13–17 . In our study, direct hernia and a large-diameter hernia defect was associated with increased risk of seroma development, in accordance with the literature.…”

Section: Discussionsupporting

confidence: 91%

The Relationship Between Small Peritoneal Flap Defects and Postoperative Seroma in TAPP Repair of Inguinal Hernias

Zarbaliyev,

Turhan,

Dündar

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Objective: Total abdominal preperitoneal (TAPP) is one of the most frequently used surgical treatment methods in the treatment of inguinal hernia (IH). One of the most common early postoperative complications after hernia repair is seroma/hematoma. In this study, we aimed to study the role of unclosed peritoneal flap defects on the development of postoperative seroma. Material and Methods: The study was performed retrospectively in 2 university hospitals. All patients over the age of 18 years who underwent laparoscopic TAPP surgery in Istanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital General Surgery Clinic and Van Yüzüncü Yıl University Faculty of Medicine General Surgery Clinic between January 1, 2018, and December 31, 2021, were included. Patients were divided into those with peritoneal defects (group 1) and those without (group 2). Whether there was a peritoneal defect or not was compiled from video recordings. In addition, risk factors affecting the development of seroma were determined. Results: A total of 250 patients, 16 (6.4%) women and 234 (93.6%) men, were included in the study. There were bilateral hernias in 35 (14%) patients, and a total of 320 hernias were analyzed in the study. It was determined that an American Society of Anaesthesiologists (ASA) III score increased the risk of seroma 15.97 fold (P<0.001, 95% CI, 4.94 to 51.56), direct hernia type increased risk 7.1 fold (P<0.03, 95% CI, 1.204 to 42.422), hernia descending into scrotum increased risk 22.48 fold (P<0.001, 95% CI, 6.66 to 75.84) and closure of the peritoneal flap completely without leaving any defect increased the risk of seroma 8.67 fold (P<0.001, 95% CI, 3.254 to 23.115). Conclusions: The presence or leaving of small-diameter defects on the peritoneal flap may reduce seroma development without increasing the risk of complications. Prospective randomized studies are required to reach definitive conclusions.

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“…[18][19][20][21] The introduction of fluid into the preperitoneal space serves to enhance the dissection process in TAPP inguinal hernia repair, mitigating the potential for undue harm to adjacent tissues. 22 Identification and protection of the vas deferens, spermatic arteries, and epigastric vessels inside the abdominal cavity is technically challenging, particularly for surgeons and surgical trainees who have minimal expertise with TAPP procedures. Lovisetto et al 11 reported a 4.6% incidence of intraoperative complications in the context of TAPP surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of modified tumescent and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair: a retrospective clinical study

Hu,

Zhang,

Wang

et al. 2024

J Int Med Res

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Objective Laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair poses certain challenges to less experienced surgeons. This study was performed to compare the clinical outcomes of modified tumescent laparoscopic TAPP (MT-TAPP) inguinal hernia repair versus conventional laparoscopic TAPP (CL-TAPP) inguinal hernia repair. Methods We retrospectively analyzed the perioperative data of patients with inguinal hernias who underwent either MT-TAPP repair (n = 57) or CL-TAPP repair (n = 54) at the General Surgery Department of Nanjing Yimin Hospital from November 2019 to June 2023. Results The durations of the total operation and the preperitoneal space dissection were shorter in the MT-TAPP than CL-TAPP group. The estimated blood loss volume was lower in the MT-TAPP than CL-TAPP group. The visual analogue scale scores recorded at the 12- and 24-hour postoperative time points showed significantly greater reductions in the MT-TAPP than CL-TAPP group. Conclusions Using liquid injection and gauze dissection is both safe and practical. This technique results in a shortened total operation time, less time spent on preperitoneal space dissection, decreased estimated blood loss, and less severe postoperative pain.

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Investigation of risk factors for postoperative seroma/hematoma after TAPP

Cited by 13 publications

References 19 publications

Modified Frailty Index and Albumin-Fibrinogen Ratio Predicts Postoperative Seroma After Laparoscopic TAPP

Modified Frailty Index and Albumin-Fibrinogen Ratio Predicts Postoperative Seroma After Laparoscopic TAPP

The Relationship Between Small Peritoneal Flap Defects and Postoperative Seroma in TAPP Repair of Inguinal Hernias

Comparison of modified tumescent and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair: a retrospective clinical study

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