ObjectiveTo analyze the effects of hernia sac transection on seroma of indirect hernia sac larger than 5 cm in diameter after transabdominal preperitoneal (TAPP) hernia repair and its related factors. MethodsThe clinical data of 108 male patients with inguinal indirect hernia were retrospectively analyzed. The patients were assigned to observation group and control group according to the surgical regimen. The observation group enrolled 57 cases and was treated with hernia sac transection in TAPP hernia repair, whereas the control group enrolled 51 cases and was employed with total hernia sac dissection in TAPP hernia repair. Surgical related indices, postoperative pain states, and postoperative seroma occurrence were compared between both groups. Univariate analysis and multivariate logistic regression models were used to analyze the influencing factors for the occurrence of seroma after TAPP hernia repair. Results(1) The observation group exhibited less intraoperative bleeding volume, shorter operation duration and out-of-bed activity time as compared with the control group (all P＜0.05), whereas the difference of postoperative hospital stays was not statistically significant (P＞0.05); furthermore, the postoperative prevalence of seroma was lower in the observation group than in the control group (1.75% vs. 13.73%, P＜0.05); in addition, concerning the VAS scores, both groups expressed lower scores on the first day after operation than one day before operation, and the observation group yielded a lower score as compared with the control group on the first day after operation (all P＜0.05). (2) Univariate analysis interpreted that no statistically significant differences were found in age, BMI, operation duration, patch types, and preoperative complications (all P＞0.05), whereas the differences of processing modes of hernia sac, courses of disease were statistically significant between patients with and without seroma (all P＜0.05); additionally, multivariate logistic regression analysis revealed that course of disease ≥ 5 years was the risk factor for the occurrence of seroma after TAPP hernia repair (P＜0.05), and processing modes of hernia sac transection was the protective factor for the occurrence of seroma after TAPP hernia repair (P＜0.05). ConclusionHernia sac transection in TAPP hernia repair for treating patients with indirect hernia sac larger than 5 cm in diameter is safe, effective, and can effectively decrease the incidence of postoperative seroma occurrence. Course of disease ≥ 5 years, or processing modes of hernia sac transection was the risk or protective factor for the occurrence of seroma after TAPP hernia repair, respectively. Clinics ought to employ safe and effective surgical methods based on combining disease courses of patients.

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