Preperitoneal closed-system suction drainage after totally extraperitoneal hernioplasty in the prevention of early seroma formation: a prospective double-blind randomised controlled trial

Fan, Jicong; Liu, J.; Chen, K.; Yang, Xuefei; Xu, Xinhui; Choi, Hok Kwok; Chan, F.H.Y.; Chiu, K.W.; Lo, C. P.

doi:10.1007/s10029-018-1731-2

Cited by 33 publications

(39 citation statements)

References 17 publications

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“…Drainage was found to be associated with a significant reduction in the seroma rate up to postoperative day 6 [95]. The authors concluded that drainage of the extraperitoneal space in TEP reduced the seroma rate in the early postoperative phase [95].…”

Section: Drainage After Tepmentioning

confidence: 93%

Section: Drainage After Tepmentioning

confidence: 99%

“…In one RCT with 90 patients, TEP repair of primary unilateral inguinal hernia with drainage vs non-drainage was compared [95]. Drainage was found to be associated with a significant reduction in the seroma rate up to postoperative day 6 [95]. The authors concluded that drainage of the extraperitoneal space in TEP reduced the seroma rate in the early postoperative phase [95].…”

Section: Drainage After Tepmentioning

confidence: 99%

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TEP for elective primary unilateral inguinal hernia repair in men: what do we know?

Köckerling

2019

Hernia

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Introduction Based on the new international guidelines for groin hernia management, there is no one surgical technique that is suited to all patient characteristics and diagnostic findings. Therefore, a tailored approach should be used. Here, a distinction must be made between primary unilateral inguinal hernia in men and in women, bilateral inguinal hernia, scrotal inguinal hernia, inguinal hernia following pelvic and lower abdominal procedures, patients with severe cardiopulmonary complications, recurrent inguinal hernias and incarcerated inguinal and femoral hernias. This paper now explores the relevant studies on TEP for elective primary unilateral inguinal hernia in men, which constitutes the most common indication for repair. Material A systematic search of the available literature was performed in February 2019 using Medline, PubMed, Scopus, Embase, Springer Link and the Cochrane Library. Only meta-analyses, systematic reviews, RCTs and comparative registry studies were considered. 117 publications were identified as relevant. Results RCTs and comparative registry analyses demonstrated the advantages of TEP with regard to postoperative complications, complication-related reoperations, and postoperative and chronic pain compared with Lichtenstein repair for elective primary unilateral inguinal hernia repair in men. No relevant differences were found compared with TAPP. Mesh fixation is not needed in TEP, but heavyweight meshes result in a lower recurrence rate. Extraperitoneal bupivacaine analgesia vs placebo does not demonstrate any advantages, but drainage is advantageous for seroma prophylaxis. The risk of chronic pain is negatively influenced by small defects, younger patient age, preoperative pain, higher BMI, postoperative complications, higher ASA score and risk factors. Conclusion For the subgroup of elective primary unilateral inguinal hernia in men, accounting for a proportion of less than 50% of the total collective, advantages were identified for TEP compared with open Lichtenstein repair but not versus TAPP.

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Section: Drainage After Tepmentioning

confidence: 93%

Section: Drainage After Tepmentioning

confidence: 99%

Section: Drainage After Tepmentioning

confidence: 99%

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TEP for elective primary unilateral inguinal hernia repair in men: what do we know?

Köckerling

2019

Hernia

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“…Berney et al 8 instead of inverting the transversalis fascia described the use of endoloops to systematically close big direct defects before the mesh placement, achieving encouraging results. Finally, also fibrin sealant 16 and the use of drains [17][18][19] showed promising results in reducing seroma formation.…”

Section: Discussionmentioning

confidence: 99%

Suture and Fixation of the Transversalis Fascia during Robotic-Assisted Transabdominal Preperitoneal Hernia Repair to Prevent Seroma Formation after Direct Inguinal Hernia Repair

et al. 2020

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Background. Seroma formation after videoendoscopic repair of inguinal hernias, known as “pseudorecurrence”, may vary from an asymptomatic, self-limiting occurrence to a painful, chronic problem. The aim of this study was to investigate the incidence of postoperative seroma in robotic-assisted transabdominal preperitoneal hernia repair (R-TAPP), modified by suturing and fixating the transversalis fascia to the Cooper ligament. Methods. The study was approved by the local ethics committee (2019-01132 CE-3495). Patients undergoing R-TAPP for direct inguinal hernia from October 2017 to December 2019 were included. In all patients, a barbed running suture of the transversalis fascia was performed to close the cavity resulting from the direct hernia reduction and to fix it to the Cooper ligament, then a lightweight mesh was placed. Demographic and clinical data were collected and analysed. Results. Over the study period, 67 R-TAPP in 51 patients were identified. All patients were male, with a mean age of 63.1 ± 12.7 years. There was 1 case of conversion to open surgery due to adhesions of the caecum to the groin as a result of perforated appendicitis. The mean length of the hospital stay was 1.8 ± .6 days. After discharge, no cases of seroma or recurrence at 30 days nor chronic pain at a mean follow-up of 10.3 ± 6.8 months was detected. Conclusions. In the treatment of direct inguinal hernia with R-TAPP, suturing and anchoring the transversalis fascia to the Cooper ligament are safe, feasible and recommendable in order to prevent postoperative seromas.

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“…112 En el año 2018, Fan realizó el análisis de la utilidad del drenaje en 78 pacientes y demostró un descenso significativo en la formación y tamaño del seroma luego de la hernioplastia laparoscópica. 113 Paasch, en el mismo año, describió que el drenaje podría disminuir la formación de seromas, aunque sostiene que se necesitan más ensayos clínicos para confirmar esa hipótesis. 114 Nuestra experiencia no mostró beneficios en la disminución de seromas en el postoperatorio al colocar un drenaje; en la figura 37 presentamos nuestros resultados donde no encontramos diferencia en la aparición de seroma en ambos grupos (45,2% vs 40%).…”

Section: Discussionunclassified

Utilidad del drenaje en eventroplastias con malla

Tejerizo¹,

Bartoli²,

Dreizzen³

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Introducción: La reparación de las eventraciones presenta alta tasa de complicaciones, el seroma y la infección del sitio quirúrgico están entre las más frecuentes. Los drenajes son frecuentemente colocados durante la reparación de una eventración para facilitar la salida del líquido y prevenir la aparición de complicaciones. No existe consenso sobre su utilidad. Objetivos: Determinar si la utilización de drenajes en las eventroplastias con malla influye en la aparición de complicaciones. Materiales y Métodos: Realizamos un estudio observacional de cohortes, comparando prospectivamente dos grupos de pacientes operados, unos con colocación de drenaje y otro sin ellos. Resultados: Incluimos 102 pacientes, 42 en el grupo con drenaje y 60 en el grupo sin drenaje. No encontramos diferencia estadísticamente significativa en el desarrollo de complicaciones en base a la colocación de drenaje (p = 0,619). Conclusiones: La aparición de complicaciones en una intervención quirúrgica depende de múltiples factores; la edad, la diabetes y el estado nutricional, parecieran ser los más significativos. Los pacientes con IMC elevado (≥ 30) y eventraciones ≥10 cm desarrollaron con mayor frecuencia complicaciones de la herida. No encontramos que la colocación de un drenaje en las eventroplastias con malla influye en la aparición de complicaciones durante el postoperatorio.

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Preperitoneal closed-system suction drainage after totally extraperitoneal hernioplasty in the prevention of early seroma formation: a prospective double-blind randomised controlled trial

Cited by 33 publications

References 17 publications

TEP for elective primary unilateral inguinal hernia repair in men: what do we know?

TEP for elective primary unilateral inguinal hernia repair in men: what do we know?

Suture and Fixation of the Transversalis Fascia during Robotic-Assisted Transabdominal Preperitoneal Hernia Repair to Prevent Seroma Formation after Direct Inguinal Hernia Repair

Utilidad del drenaje en eventroplastias con malla

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