Evidence map›Paper›PMID 29075973›Full record

ArticleSurgical endoscopy2018

Seroma following transabdominal preperitoneal patch plasty (TAPP): incidence, risk factors, and preventive measures.

F Köckerling, R Bittner, D Adolf, R Fortelny, H Niebuhr, F Mayer, C Schug-Pass

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06389331 (A Comparative Study on Effects of Defect Closure Versus Non-Closure in Laparoscopic Totally Extraperitoneal Repair of Direct Inguinal Hernia), which is not on this map. Cited by 36 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06389331 completednot on this mapstarted 2020, after this paper: background citation

A Comparative Study on Effects of Defect Closure Versus Non-Closure in Laparoscopic Totally Extraperitoneal Repair of Direct Inguinal Hernia

TypeobservationalSponsorB.P. Koirala Institute of Health SciencesRan2020 to 2021Enrolled88ConditionsHernia, Direct Inguinal Hernia, Seroma Following ProcedureArmsclosed the defect with barbed suture
3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  13. To close or not to close the deep inguinal ring in laparoscopic hernia repair. A comparative study.Hernia : the journal of hernias and abdominal wall surgery · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

F KöckerlingDepartment of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany. ferdinand.koeckerling@vivantes.de.
R BittnerHernia Center, Winghofer Medicum, Winghofer Strasse 42, 72108, Rottenburg am Neckar, Germany.
D AdolfStatConsult GmbH, Halberstädter Strasse 40 a, 39112, Magdeburg, Germany.
R FortelnyDepartment of General, Visceral and Oncologic Surgery, Wilhelminenhospital, Montleartstrasse 37, 1160, Vienna, Austria.
H NiebuhrHanse-Hernia Center, Alte Holstenstrasse 16, 21031, Hamburg, Germany.
F MayerDepartment of Surgery, Paracelsus Medical University, Müllnerhauptstrasse 48, 5020, Salzburg, Austria.
C Schug-PassDepartment of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe reported range of seroma formation in the literature after TEP repair is between 0.5 and 12.2% and for TAPP between 3.0 and 8.0%. Significant clinical factors associated with seroma formation include old age, a large hernia defect, an extension of the hernia sac into the scrotum, as well as the presence of a residual indirect sac. Seroma formation is a frequent complication of laparoendoscopic mesh repair of moderate to large-size direct (medial) inguinal hernia defects. This present analysis of data from the Herniamed Hernia Registry now explores the influencing factors for seroma formation in male patients after TAPP repair of primary unilateral inguinal hernia.

methodsIn total, 20,004 male patients with TAPP repair of primary unilateral inguinal hernia were included in uni- and multivariable analysis.

resultsUnivariable analysis revealed the highly significant impact of the fixation technique on the seroma rate (non-fixation 0.7% vs. tacks 2.1% vs. glue 3.9%; p < 0.001). Multivariable analysis showed that glue compared to tacks (OR 2.077 [1.650; 2.613]; p < 0.001) and non-fixation (OR 5.448 [4.056; 7.317]; p < 0.001) led to an increased seroma rate. A large hernia defect (III vs. I: OR 2.868 [1.815; 4.531]; p < 0.001; II vs. I: OR 2.157 [1.410; 3.300]; p < 0.001) presented a significantly higher risk of seroma formation. Likewise, medial compared to lateral inguinal hernias had a higher seroma rate (OR 1.272 [1.020; 1.585]; p = 0.032).

conclusionsMesh fixation with tacks or glue, a larger hernia defect, and medial defect localization present a higher risk for seroma development in TAPP inguinal hernia repair.

Indexed as

AdultHernia, InguinalHerniorrhaphyHumansIncidenceMaleMiddle AgedProspective StudiesRisk FactorsSeromaSurgical MeshTreatment OutcomeComplicationsInguinal herniaMesh fixationSeromaTAPP

Identifiers

PMID29075973
PMCPMC5897456

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.