Effect of preperitoneal negative-pressure drainage in laparoscopic transabdominal preperitoneal inguinal hernia...

This study aims to investigate the effect of preperitoneal drainage on complications after transabdominal preperitoneal (TAPP) inguinal hernia repair.

Patients undergoing TAPP repair between August 2022 and June 2025 were included, and baseline characteristics were collected retrospectively. Outcomes included post-operative hospital stays, post-operative pain and post-operative complications. Patients were divided into two groups based on whether a drain tube was placed or not. The propensity score matching (PSM) method was used to obtain homogeneous comparison groups. Univariate and multivariate logistic regression models were used to analyse the risk factors of post-operative complications.

Seven hundred and seventy-two patients were enrolled and divided into drainage group of 133 patients and non-drainage group of 639 patients. The first 2 days after TAPP repair were the peak period for drainage volume, with a mean volume of 48.4 ml on post-operative day 1 and 37.6 ml on post-operative day 2. After PSM, drainage group had significantly longer post-operative hospital stay (3.4 ± 0.9 vs. 1.5 ± 0.8 days, P < 0.001), less pain after post-operative 6 h (0% vs. 1.7%, P = 0.041), fewer seroma (0.8% vs. 6.6%, P = 0.007) and more incisional infection (4.5% vs. 1.1%, P = 0.005). Multivariate logistic regression models exhibited that the placement of a drain tube significantly reduced the incidence of seroma (odds ratio [OR] =0.101, P = 0.029) and, however, increased the incidence of incisional infection (OR = 9.663, P = 0.014).

The placement of drain tube after TAPP inguinal hernia repair effectively reduces the risk of seroma formation. However, the timing of removing the drain tube should be evaluated carefully to prevent the occurrence of incisional infection.