Laparoscopic total extraperitoneal inguinal hernia repair is safe and feasible in patients with continuation of antithrombotics
Chen-Hsun Ho1, Chia-Chang Wu1, Chao-Chuan Wu2, Yao-Chou Tsai3
1 Department of Urology, School of Medicine, College of Medicine; Department of Urology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
2 Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
3 Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei; Department of Urology, Medical College, Tzu Chi University, Hualien, Taiwan
Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, 289 Jianguo Road, Xindian, Taipei
Source of Support: None, Conflict of Interest: None
Aims: We aimed to evaluate the safety and feasibility of laparoscopic total extraperitoneal (TEP) inguinal hernia repair in patients with the continuation of their antithrombotic agents.
Settings and Design: This was prospective cohort study.
Materials and Methods: A total of 115 patients who underwent TEP inguinal hernia repair between January 2015 and September 2016 were included in the analysis. Seventeen patients continued their antithrombotics (antithrombotic group); the other 98 had not been on antithrombotics (control group).
Statistical Analysis Used: The analysis was performed by using Mann–Whitney U-test, Chi-square or Fisher's exact test.
Results: The antithrombotic group had a greater mean age (65.9 ± 8.0 vs. 57.7 ± 13.6, P = 0.002) and higher prevalence of hypertension (64.7% vs. 33.7%, P = 0.015), cardiovascular diseases (64.7% vs. 7.1%, P < 0.001), atrial fibrillation (23.5% vs. 0, P < 0.001), ischaemic heart disease (35.3% vs. 0, P < 0.001) and the American Society of Anaesthesiologists ≥2 (94.1% vs. 81.6%, P = 0.005). The operation time for the antithrombotic group was longer than that of the control group (92.06 ± 32.81 min vs. 72.33 ± 20.99 min, P = 0.015). None experienced conversion to open surgery in either group. There was no difference in the post-operative complications (29.4% vs. 28.6%) and sero-haematoma formation (23.5% vs. 11.1%). The analgesic requirement, hospital stays (23.72 ± 7.74 vs. 22.35 ± 10.33 h) and the time for return to normal daily activity (3.56 ± 1.74 vs. 3.63 ± 1.90) were not statistically different between the two groups. None in either group experienced major cardiovascular events within 30 days.
Conclusions: Laparoscopic TEP inguinal hernia repair can be safely performed in patients with the continuation of their antithrombotic agents in experienced hands.