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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

Overview of attention for article published in Hernia, January 2018
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Title
Preperitoneal closed-system suction drainage after totally extraperitoneal hernioplasty in the prevention of early seroma formation: a prospective double-blind randomised controlled trial
Published in
Hernia, January 2018
DOI 10.1007/s10029-018-1731-2
Pubmed ID
Authors

J. K. M. Fan, J. Liu, K. Chen, X. Yang, X. Xu, H. K. Choi, F. S. Y. Chan, K. W. H. Chiu, C. M. Lo

Abstract

Seroma is a virtually unavoidable early sequela after TEP hernioplasty. This randomised controlled trial evaluated the outcomes of preperitoneal closed-system suction drainage in laparoscopic totally extraperitoneal (TEP) hernioplasty for inguinal hernia. Ninety patients aged 18-80 years who presented to our hospital between May 2016 and February 2017 with primary unilateral inguinal hernia were randomised into the preperitoneal drain and no-drain groups. The primary outcome was seroma size on postoperative day 6. Secondary outcomes included clinical seroma formation and seroma size on day 1, day 6, 1 and 7 months postoperatively, length of postoperative stay, pain score, and recurrence. There was no significant difference in age, sex, co-morbidities, hernia side, mean hernia size, operating time, fixation adjuncts, or postoperative stay. The overall incidence of clinical seroma formation was 25.6% on postoperative day 1, 60.3% on postoperative day 6, 13.2% 1 month and 0% 7 months postoperatively. The mean drain output was 57.9 ml. The drain group had significantly fewer patients with seroma on day 1 (6 vs 14, p = 0.022) and day 6 (17 vs 30, p = 0.000), and a smaller mean seroma size on days 1 and 6 (p = 0.000). Subgroup analysis showed that sac ligation versus reduction, peritoneal perforation, and fixation adjuncts had no significant effects on seroma formation or size. There is a trend of lower early post-operation VAS score and more urinary retention in drain group was observed but not reaching statistical significance. No differences in postoperative pain score or complications were observed at 1 and 7 months' post operation. Preperitoneal drainage for 23 h after laparoscopic TEP hernioplasty for inguinal hernia can effectively decrease seroma formation in the early postoperative period, and potentially improving postoperative pain. The benefit is short-term and no significant difference was demonstrated after 1-month post operations. This tradition technique applied to novel operative repair of inguinal hernia is safe and feasible with no significant morbidity demonstrated. Preperitoneal drainage after TEP can be considered as an option to improve patient satisfactions and recovery in selected patient group for maximal benefit, especially for those with prolonged operation which may associate with higher chance of seroma formation.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 9 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 9 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 3 33%
Unspecified 2 22%
Researcher 2 22%
Student > Doctoral Student 1 11%
Student > Master 1 11%
Other 0 0%
Readers by discipline Count As %
Medicine and Dentistry 6 67%
Unspecified 2 22%
Agricultural and Biological Sciences 1 11%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 January 2018.
All research outputs
#10,991,496
of 12,368,793 outputs
Outputs from Hernia
#381
of 547 outputs
Outputs of similar age
#332,893
of 396,285 outputs
Outputs of similar age from Hernia
#16
of 27 outputs
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