Hernia, Inguinal Clinical Trial
Official title:
Pre-peritoneal Drainage Versus No Drainage After Totally Extra-peritoneal Hernioplasty for Inguinal Hernia - a Randomised Controlled Study
This is a RCT on drain versus no drain after laparoscopic totally extra-peritoneal hernioplasty. We will assess the difference in seroma formation after surgery in 2 two groups by an independent assessor clinically and radiologist to document the size of seroma after surgery. Other secondary outcomes will be measured including post-operative pain, discomfort, analgesic used, patient satisfaction, recurrence of hernia, wound infection, etc.
Inguinal hernia is a common disease and causes significant morbidity if left untreated. With
the advances of laparoscopic approach of extra-peritoneal hernioplasty, it significantly
reduces the post-operative pain and lead to a better quality of life with higher acceptance
to patients.However, similar to traditional Litchenstein approach, post operative seroma
formation is still a common problem encountered after surgery. Numerous method has been
described to reduce chance of seroma formation, however, none was proven to be effective
except pre-peritoneal drainage. There are currently 2 large retrospective non-randomized
cohort study to evaluate the effectiveness of preperitoneal drainage available for
reference. We therefore study the feasibility and efficacy of preperitoneal drainage with
large scale randomized trial.
Patient fulfill inclusion criteria and consent to surgery and study will be recruited. A
standardized pre-peritoneal dissection and mesh placement will be adopted. Immediately
before deflation of pre-peritoneal space, randomization will be performed by calling
research assistant for study group using computer generated code. Drain will be placed for
23 hours after operation and ultrasonography will be performed immediately after removal of
drain. USG will be repeated at post-operative 1 week, 1 month, 3 months, 6 months and 1 year
after surgery. For non-drain group, a fake drain will be attach to the skin of the wound to
achieve double blinding to patients and assessors. In addition to seroma, patient
demographics and secondary outcome including post-operative pain score, discomfort, foreign
body sensation, patient satisfaction, infection, recurrence, etc will be studied.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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