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Meta-Analysis
. 2024 Mar 15;103(11):e37412.
doi: 10.1097/MD.0000000000037412.

Routine closed-suction drainage reduces seromas following totally extraperitoneal (TEP) inguinal hernia repair: A meta-analysis

Dimitrios Prassas  1   2 , Michael Zaczek  1 , Stephan Oliver David  2 , Wolfram Trudo Knoefel  2 , Sascha Vaghiri  2
Affiliations
Meta-Analysis

Routine closed-suction drainage reduces seromas following totally extraperitoneal (TEP) inguinal hernia repair: A meta-analysis

Dimitrios Prassas et al. Medicine (Baltimore). .

Abstract

Background: The value of prophylactic closed-suction drainage in totally extraperitoneal inguinal hernia repair (TEP) is still a matter of controversy. We conducted a meta-analysis of studies examining postoperative seroma rates in patients with or without routine placement of closed-suction drainage tubes.

Methods: A systematic literature search was conducted for trials comparing the outcome of TEP with or without routine drainage placement. Data regarding postoperative outcomes were extracted and compared by meta-analysis. The odds ratio and standardized mean differences with 95% confidence intervals were calculated.

Results: Four studies were identified, involving a total of 1626 cases (Drain: n = 1251, no Drain: n = 375). There was a statistically significant difference noted between the 2 groups regarding postoperative seroma formation favoring the Drain group (odds ratio = 0.12; 95% confidence intervals [0.05, 0.29]; P < .001; 4 studies; I2 = 72%). For the remaining secondary endpoints postoperative urinary retention, recurrence, mesh infection and in-hospital length of stay no statistically significant difference was noted between the 2 study groups.

Conclusion: Current evidence suggests that patients who underwent TEP with routine closed-suction drain placement developed significantly fewer seromas without any additional morbidity or prolongation of in-hospital stay.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flow chart.
Figure 2.
Figure 2.
Potential sources of Bias—Robins 1.
Figure 3.
Figure 3.
Potential sources of Bias—RoB2.
Figure 4.
Figure 4.
Postoperative seroma.
Figure 5.
Figure 5.
Urinary retention.
Figure 6.
Figure 6.
In-hospital stay.
Figure 7.
Figure 7.
Recurrence.
See this image and copyright information in PMC

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