Mehdi Fesharakizadeh, MD1, P Haghighatjoo, MD2, Sh Dolatkhah3, Sh Fesharakizadeh4, H Saeedimotahar1. 1Iranmehr Hospital, Tehran, Iran, 2Kashani Hospital, Shahrekord, Iran, 3Isfahan University of Medical Sciences, Isfahan, Iran, 4San Francisco State University, CA, USA
BACKGROUND: Both hematoma and /or seroma are well known complications of laparoscopic inguinal hernia surgery, either TAPP or TEP techniques. Management is usually conservative, but considerably results in increased morbidity including pain. Sometimes repeated aspirations are mandatory, in addition to the increased risk of infection. In this randomized controlled trial was aimed to find the effect of drain placement in patients with inguinal hernia who underwent Total Abdominal Preperitoneal (TAPP) repair.
METHODS: A total of 60 patients with inguinal hernias were randomized to two equal groups, each group including 30. All of them were operated by the same surgeon. The surgical technique employed was TAPP repair. In one group, a closed suction drain was inserted through the lateral 5 mm port. In the second group, the drain wasn’t applied. Then the results were compared between the two groups.
RESULTS: In 60 patients (60 hernias), the closed suction drain was inserted in 30 and the rest of the patients (30) were left without a drain. After surgery, all the patients were examined to find formation of any hematomas and/or seromas. They were followed for 3 months after surgery. Formation of hematoma and/or seroma was significantly lower in the drain group (4/30; 13.3%) compared with the no drain group (13/30; 43.3%) (p<0.0001). The no drain group experienced higher levels of postoperative pain, although not significant, seemed to originate from the hematoma or seroma itself. As expectable; a mass could be found with a higher incidence in no drain group; statistically significant (p=0.002).
CONCLUSIONS: Insertion of drain significantly results in the reduction of hematoma and/or seroma formation in patients undergoing TAPP hernia repair. The authors suggest studies with larger sample sizes to permit more accurate statistics.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87981
Program Number: S004
Presentation Session: Hernia Session
Presentation Type: Podium