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Seroma following endoscopic extraperitoneal inguinal hernioplasty

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Abstract

Background: Because it mimics a postoperative recurrence of hernia, seroma has been a concern to patients. There has been no consensus on the management of this condition after endoscopic totally extraperitoneal inguinal hernioplasty (TEP). The objectives of the present study were to evaluate the incidence and treatment of seroma after TEP. Risk factors for the development of seroma were also examined. Methods: A total of 450 consecutive patients who underwent TEP between June 1999 and May 2002 were recruited. All data were collected prospectively. The outcomes of patients who developed seromas were compared to those without this postoperative complication. Regression analysis was performed to identify independent risk factors for seroma formation. Results: The overall incidence of seroma formation was 7.2% (n = 40). The postoperative recovery of patients was not influenced by the development of seroma. The mean size of the seromas was 3.8 cm. Adopted treatment strategies included observation (n = 29), oral lysozyme (n = 10), and percutaneous aspiration (n = 3), but neither of the two interventions appeared to be effective. The seromas resolved spontaneously by an average of 2.4 (mean) months. Significant clinical factors associated with seroma formation included old age, large hernial defects, an extension of the hernia into the scrotum, and the presence of a residual distal indirect sac. By logistic regression, a large hernial defect and an extension of the hernia into the scrotum were found to be independent risk factors for seroma formation. Conclusions: Although seroma is a frequent minor morbidity after TEP, it has no impact on postoperative recovery. Because all seromas invariably resolve, expectant treatment with observation is recommended. Inguinoscrotal hernia carries a four-fold increased risk of developing seroma after TEP.

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References

  1. P Aeberhard C Klaiber A Meyenberg A Osterwalder J Tschudi (1999) ArticleTitleProspective audit of laparoscopic totally extraperitoneal inguinal hernia repair: a multicenter study of the Swiss Association for Laparoscopic and Thoracoscopic Surgery (SALTC) Surg Endosc 13 1115–1120 Occurrence Handle10556450

    PubMed  Google Scholar 

  2. DR Aitken R Hunsaker AG James (1984) ArticleTitlePrevention of seromas following mastectomy axillary dissection. Surg Gynecol Obstet 158 327–330 Occurrence Handle1:STN:280:BiuC2s3mt1U%3D Occurrence Handle6369582

    CAS  PubMed  Google Scholar 

  3. R Bendavid M Kux (2001) Seromas. R Bendavid J Abrahamson ME Arregui JB Flament EH Phillips (Eds) Abdominal wall hernias: principles and management. Springer New York 753–756

    Google Scholar 

  4. R Bittner B Kraft B Kuckuk B Leibl K Kraft (2002) Ultrasound examination in laparoscopic/endoscopic hernia surgery. RJ Fitzgibbons Jr AG Greenburg (Eds) Nyhus & Condon’s hernia. Lippincott Williams & Wilkins Philadelphia 95–102

    Google Scholar 

  5. WE Burak Jr PS Goodman DC Young WB Farrar (1997) ArticleTitleSeroma formation following axillary dissection for breast cancer: risk factors and lack of influence of bovine thrombin. J Surg Oncol 64 27–31 Occurrence Handle10.1002/(SICI)1096-9098(199701)64:1<27::AID-JSO6>3.3.CO;2-9 Occurrence Handle1:STN:280:ByiC1MzitVE%3D Occurrence Handle9040797

    Article  CAS  PubMed  Google Scholar 

  6. AE Cameron SR Ebbs F Wylie M Baum (1988) ArticleTitleSuction drainage of the axilla: a prospective randomized trial. Br J Surg 75 1211 Occurrence Handle1:STN:280:BiaC28jlsVM%3D Occurrence Handle3069178

    CAS  PubMed  Google Scholar 

  7. CY Chen AL Hoe CY Wong (1998) ArticleTitleThe effect of a pressure garment on post-surgical drainage and seroma formation in breast cancer patients. Sing Med J 39 412–415 Occurrence Handle1:STN:280:DyaK1M7gtlWjtQ%3D%3D

    CAS  Google Scholar 

  8. GS Ferzli T Kiel (1996) ArticleTitleThe role of endoscopic extraperitoneal approach in large inguinal scrotal hernias. Surg Endosc 11 299–302 Occurrence Handle10.1007/s004649900350

    Article  Google Scholar 

  9. CJ Filipi (2002) The transabdominal preperitoneal laparoscopic herniorrhaphy. RJ Fitzgibbons Jr AG Greenburg (Eds) Nyhus & Condon’s hernia. Lippincott Williams & Wilkins Philadelphia 255–268

    Google Scholar 

  10. RJ Fitzgibbons Jr J Camps DA Cornet NX Nguyen BS Litke R Annibali GM Salerno (1995) ArticleTitleLaparoscopic inguinal herniorrhaphy: results of a multicenter trial. Ann Surg 221 3–13 Occurrence Handle7826159

    PubMed  Google Scholar 

  11. C Jehaes (1995) Laparoscopic extraperitoneal approach for inguinal hernia repair in Inguinal hernia repair. V Schumpelick GE Wantz (Eds) Inguinal hernia repair. Karger Basel 269–272

    Google Scholar 

  12. SA Kapiris WA Brough CM Royston C O’Boyle PC Sedman (2001) ArticleTitleLaparoscopic transabdominal preperitoneal (TAPP) hernia repair: a 7-year two-center experience in 3017 patients. Surg Endosc 15 972–975 Occurrence Handle10.1007/s004640080090 Occurrence Handle1:STN:280:DC%2BD3MrlvVCrsw%3D%3D Occurrence Handle11605111

    Article  CAS  PubMed  Google Scholar 

  13. DA Kulbar N Bacilious ED Peters LB Gayle L Hoffman (1997) ArticleTitleThe use of fibrin sealant in the prevention of seromas. Plast Reconstr Surg 99 842–849 Occurrence Handle10.1097/00006534-199703000-00034 Occurrence Handle9047205

    Article  PubMed  Google Scholar 

  14. SC Lehr AL Schuricht (2001) ArticleTitleA minimally invasive approach for treating postoperative seromas after incisional hernia repair. JSLS 5 267–271 Occurrence Handle1:STN:280:DC%2BD3MvpvFOiuw%3D%3D Occurrence Handle11548834

    CAS  PubMed  Google Scholar 

  15. BJ Leibl CG Schmedt K Kraft M Ulrich R Bittner (2000) ArticleTitleScrotal hernias: a contraindication for an endoscopic procedure? Results of a single-institution experience in transabdominal preperitoneal repair. Surg Endosc 14 289–292 Occurrence Handle1:STN:280:DC%2BD3c3gtlCqtw%3D%3D Occurrence Handle10741451

    CAS  PubMed  Google Scholar 

  16. DE Litwin QN Pham FH Oleniuk AM Kluftinger L Rossi (1997) ArticleTitleLaparoscopic groin hernia surgery: the TAPP procedure. Transabdominal preperitoneal hernia repair. Can J Surg 40 192–198 Occurrence Handle1:STN:280:ByiA3sfitF0%3D Occurrence Handle9194780

    CAS  PubMed  Google Scholar 

  17. InstitutionalAuthorNameMedical Research Council Laparoscopic Groin Hernia Trial Group (1999) ArticleTitleLaparoscopic versus open repair of groin hernia: a randomized comparison. Lancet 354 185–190 Occurrence Handle10421299

    PubMed  Google Scholar 

  18. BJ O’Hea MN Ho JA Petrek (1999) ArticleTitleExternal compression dressing versus standard dressing after auxillary lymphadenectomy. Am J Surg 177 450–453 Occurrence Handle10.1016/S0002-9610(99)00089-6 Occurrence Handle1:STN:280:DyaK1MzktFKmtQ%3D%3D Occurrence Handle10414691

    Article  CAS  PubMed  Google Scholar 

  19. DS O’Riordain P Kelly PG Horgan FB Keane WA Tanner (1999) ArticleTitleLaparoscopic extraperitoneal inguinal hernia repair in the day-care setting. Surg Endosc 13 914–917 Occurrence Handle10.1007/s004649901133 Occurrence Handle1:STN:280:DyaK1MzotVKltg%3D%3D Occurrence Handle10449852

    Article  CAS  PubMed  Google Scholar 

  20. K Papadakis AG Greenburg (2002) Preperitoneal hernia repair. RJ Fitzgibbons Jr AG Greenburg (Eds) Nyhus & Condon’s hernia Lippincott Williams & Wilkins Philadelphia 181–198

    Google Scholar 

  21. A Park DW Birch P Lovrics (1998) ArticleTitleLaparoscopic and open incisional hernia repair: a comparison study. Surgery 124 816–822 Occurrence Handle9781006

    PubMed  Google Scholar 

  22. RS Smith (1971) ArticleTitleThe use of prosthetic materials in the repair of hernias. Surg Clin North Am 51 1387–1399 Occurrence Handle1:STN:280:CS2D28bislE%3D Occurrence Handle4256971

    CAS  PubMed  Google Scholar 

  23. S Susmallian G Gewurtz T Ezri I Charuzi (2001) ArticleTitleSeroma after laparoscopic repair of hernia with PTFE patch: is it really a complication? Hernia 5 139–141 Occurrence Handle1:STN:280:DC%2BD38%2Fjt1egsw%3D%3D Occurrence Handle11759799

    CAS  PubMed  Google Scholar 

  24. FK Toy RW Baily S Carey CW Chappuis M Gagner LG Josephs EC Mangiante AE Park A Pomp RT Jr Smoot JF Jr Uddo GR Voeller (1998) ArticleTitleProspective, multicenter study of laparoscopic ventral hernioplasty: preliminary results. Surg Endosc 12 955–959 Occurrence Handle1:STN:280:DyaK1c3pvVeiug%3D%3D Occurrence Handle9632869

    CAS  PubMed  Google Scholar 

  25. EC Tsimoyiannis P Siakas G Glantzounis S Koulas P Mavridou KI Gossios (2001) ArticleTitleSeroma in laparoscopic ventral hernioplasty. Surg Laparosc Endosc 11 317–321 Occurrence Handle1:STN:280:DC%2BD3MrmsFChsg%3D%3D Occurrence Handle11668229

    CAS  PubMed  Google Scholar 

  26. TJ White MC Santos CJ Thompson (1998) ArticleTitleFactors affecting wound complications in repair of ventral hernias. Am Surg 64 276–280 Occurrence Handle1:STN:280:DyaK1c7otFCnsA%3D%3D Occurrence Handle9520825

    CAS  PubMed  Google Scholar 

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Acknowledgements

We acknowledge the kind assistance of Tze-Ching Tan, M.D., in editing the manuscript.

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  1. Department of Surgery, University of Hong Kong Medical Center, Tung Wah Hospital, 12 Po Yan Street, Sheung Wan, Hong Kong SAR

    H. Lau & F. Lee

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  1. H. Lau
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  2. F. Lee
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Correspondence to H. Lau.

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Lau, H., Lee, F. Seroma following endoscopic extraperitoneal inguinal hernioplasty . Surg Endosc 17, 1773–1777 (2003). https://doi.org/10.1007/s00464-002-8771-4

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