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Effects of intraoperative fixation of residual hernia sac on postoperative seroma in laparoscopic transabdominal preperitoneal inguinal hernia repair: a prospective randomized controlled trial

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Abstract

The study was aimed to evaluate a prospective randomized controlled trial (RCT) In laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP), whether fixation of the residual sac after transecting the hernia sac can reduce the severity of postoperative seroma. A total of 252 male patients with a primary unilateral indirect inguinal hernia who underwent TAPP from September 2018 to November 2022 were recruited. Patients were randomized to the control group (CG)and the experimental group (EG). In the experimental group, after the hernia sac was transected, the residual sac was fixed to the lower edge of the rectus abdominis, while it was left in the preperitoneal space in the control group. Close follow-up was arranged to observe the incidence of seroma and other postoperative complications. All 214 patients were discharged successfully. 106 patients were randomly assigned to the control group, and 108 patients were assigned to the experimental group. There was no significant difference in the incidence of postoperative fluid extraction between the experimental group and the control group (11.1% VS.10.4%, p = 0.862), but the patients with seroma after the operation had fewer repeated extraction (0% VS. 45.5%, P = 0.033). The incidences of other postoperative complications were comparable in the two groups. In the treatment of indirect inguinal hernia with TAPP, after transecting the hernia sac, suturing and fixing the residual sac to the inferior edge of the rectus abdominis can reduce the incidence of repeated aspiration.

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Author notes

  1. Han Shi and Ronggui Lin have contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People’s Republic of China

    Han Shi, Ronggui Lin, Tianhong Teng, Fengchun Lu, Yanchang Chen, Xianchao Lin, Haizong Fang, Congfei Wang, Yuanyuan Yang & Heguang Huang

  2. West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, People’s Republic of China

    Mingjing Wang

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  1. Han Shi
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  2. Ronggui Lin
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  5. Fengchun Lu
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Corresponding author

Correspondence to Heguang Huang.

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All authors declare that there is no conflict of interest.

Funding

This study was funded by the Medical Center of Minimally Invasive Technology of Fujian Province (No. 171, 2017 and No. 4, 2017) and the National Key Clinical Specialty Discipline Construction Program of China. Clinical Trail Registration No.: ChiCTR2100051134.

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The study was approved by the ethical committee of Fujian Medical University Union Hospital.

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Shi, H., Lin, R., Teng, T. et al. Effects of intraoperative fixation of residual hernia sac on postoperative seroma in laparoscopic transabdominal preperitoneal inguinal hernia repair: a prospective randomized controlled trial. Updates Surg 75, 1343–1349 (2023). https://doi.org/10.1007/s13304-022-01442-y

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  • DOI: https://doi.org/10.1007/s13304-022-01442-y

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