• Dimitrios Prassas, Michael Zaczek, Stephan Oliver David, Wolfram Trudo Knoefel, and Sascha Vaghiri.
• Katholisches Klinikum Essen, Department of Surgery, Essen Germany.
• Medicine (Baltimore). 2024 Mar 15; 103 (11): e37412e37412.

BackgroundThe 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.MethodsA 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.ResultsFour 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.ConclusionCurrent 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.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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