Do drains have an impact on the outcome after primary elective unilateral inguinal hernia repair in men?
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ORIGINAL ARTICLE
Do drains have an impact on the outcome after primary elective unilateral inguinal hernia repair in men? F. Köckerling1 · E. Hantel2 · D. Adolf3 · B. Stechemesser4 · H. Niebuhr5 · R. Lorenz6 · K. Zarras7 · F. Marusch8 Received: 27 April 2020 / Accepted: 15 June 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Introduction The use of drains continues to be a controversial topic in surgery. In a review of that topic for incisional hernia it was not possible to find sufficient evidence of the need for a drain. Likewise, for inguinal hernia surgery the data available are insufficient. Methods In a multivariable analysis of data from the Herniamed Registry for 98,321 patients with primary elective unilateral inguinal hernia repair in men, the role of a drain was investigated. Results A drain was used in 24.7% (n = 24,287/98,321) of patients. These patients were on average older, had higher BMI, longer operating time and received a smaller mesh. Drains were also used more often for patients with higher ASA score, risk factors, larger defects and scrotal hernia localization as well as for Lichtenstein, TEP and suture repair. The use of drains was highly significantly associated with intra- and postoperative complications as well as with complication-related reoperations. Hence, drains are used selectively in inguinal hernia repair for patients at higher risk of perioperative complications. Despite the use of drains, the outcome in this risk group is less favorable. It remains unclear if drains prevent further complications in high-risk patients. Conclusion Drains are used selectively in high-risk men with primary elective unilateral inguinal hernia repair. Drains are associated with intra- and postoperative complications rates and complication-related reoperation rate. Drains can serve as an indicator for early detection of complications. Keywords Inguinal hernia · Drains · Intraoperative complications · Postoperative complications · Complication-related reoperation
* F. Köckerling [email protected] 1
2
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585 Berlin, Germany Department of General, Visceral, Vascular and Thoracic Surgery, Ernst Von Bergmann Hospital, Charlottenstrasse 72, 14467 Potsdam, Germany
3
StatConsult GmbH, Halberstädter Strasse 40 a, 39112 Magdeburg, Germany
4
Hernia Center, Pan Hospital, Zeppelinstraße 1, 50667 Köln, Germany
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Hanse-Hernienzentrum, Eppendorfer Baum 8, 20249 Hamburg, Germany
6
3+Chirurgen, Klosterstraße 34/35, 13581 Berlin‑Spandau, Germany
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Department of Visceral, Minimally Invasive and Oncologic Surgery, Academic Teaching Hospital of University of Düsseldorf, Marien Hospital, Rochusstraße 2, 40479 Düsseldorf, Germany
8
Department of General, Visceral, Vascular and Thoracic Surgery, Ernst Von Bergmann Hospital, Charlottenstrasse 72, 14467 Potsdam, Germany
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