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Drain placement in retromuscular ventral hernia repair: a systematic review and meta-analysis

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Abstract

Purpose

Drain placement in retromuscular ventral hernia repair is controversial. Although it may reduce seroma formation, there is a concern regarding an increase in infectious complications. We aimed to perform a meta-analysis on retromuscular drain placement in retromuscular ventral hernia repair.

Methods

We performed a literature search of Cochrane, Scopus and PubMed databases to identify studies comparing drain placement and the absence of drain in patients undergoing retromuscular ventral hernia repair. Postoperative outcomes were assessed by pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I2 statistics.

Results

3808 studies were screened and 48 were thoroughly reviewed. Four studies comprising 1724 patients were included in the analysis. We found that drain placement was significantly associated with a decrease in seroma (OR 0.34; 95% CI 0.12–0.96; P = 0.04; I2 = 78%). Moreover, no differences were noted in surgical site infection, hematoma, surgical site occurrences or surgical site occurrences requiring procedural intervention.

Conclusions

Based on the analysis of short-term outcomes, retromuscular drain placement after retromuscular ventral hernia repair significantly reduces seroma and does not increase infectious complications. Further prospective randomized studies are necessary to confirm our findings, evaluate the optimal duration of drain placement, and report longer-term outcomes.

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Authors and Affiliations

  1. School of Medicine, Universidade Federal da Fronteira Sul, 20 Capitão Araújo St, Passo Fundo, RS, 99010121, Brazil

    P. Marcolin

  2. Department of Surgery, The University of Texas Medical Branch, Galveston, TX, USA

    S. M. P. de Figueiredo, R.-M. D. Mao & Richard Lu

  3. School of Medicine, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil

    M. M. Constante

  4. School of Medicine, Universidade Salvador, Salvador, BA, Brazil

    V. M. F. de Melo

  5. Department of Vascular Surgery, Hospital Regional Hans Dieter Schimidt, Joinville, SC, Brazil

    S. W. de Araújo

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  1. P. Marcolin
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  2. S. M. P. de Figueiredo
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  4. V. M. F. de Melo
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  7. Richard Lu
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Correspondence to P. Marcolin.

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Conflict of interest

Patrícia Marcolin, Dr. Sergio Mazzola Poli de Figueiredo, Dr. Sérgio Walmir de Araújo, Marcella Mota Constante, Vítor Moura Fé de Melo and Dr. Rui-Min Diana Mao declare that they have no conflict of interest. Dr. Richard Lu received payment/honoraria for lectures and presentations from Intuitive Surgical that are unrelated to this work.

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Marcolin, P., de Figueiredo, S.M.P., Constante, M.M. et al. Drain placement in retromuscular ventral hernia repair: a systematic review and meta-analysis. Hernia 27, 519–526 (2023). https://doi.org/10.1007/s10029-023-02792-1

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  • DOI: https://doi.org/10.1007/s10029-023-02792-1

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