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Purpose <p>This study aimed to develop a classification to precisely describe seroma following transabdominal preperitoneal hernia repair (TAPP) as well as identify risk factors and create a prediction model for seroma development.</p> Methods <p>Postoperative seroma was classified into grades 0–IV, with grades ≥ II defined as the seroma group (S group: 265 cases), which was compared with the normal course group (N group: 1,279 cases) to determine risk factors using logistic regression analysis. A prediction model was developed based on these independent predictors. Receiver operating characteristic (ROC) curve analysis was conducted to assess the discriminability and calibrability of the model. Additionally, a model to validate the incidence of seroma was used for risk stratification.</p> Results <p>This classification revealed grades 0, I, II, III, and IV in 1,194 (70.9%), 85 (5.5%), 236 (15.3%), 12 (0.8%), and 17 (1.1%) patients, respectively. Multivariate analysis revealed risk factors for seroma formation, including age of &gt; 66 years, American Society of Anesthesiologists scores of ≥ 2, surgery for recurrent hernia, size of hernia defect of &gt; 3&#xa0;cm, and duration of sickness of &gt; 1 year. The prediction model demonstrated the rates of seroma in the low, moderate, and high score groups of 10.5% (103/984), 23.7% (99/417), and 44.1% (63/143), respectively.</p> Conclusion <p>A postoperative complication of TAPP was proposed as a severity classification of seroma. A model to predict the seroma was developed based on the identified risk factors, thereby confirming the possibility of preoperative prediction of the seroma.</p>

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Severity classification and risk factors of seroma after transabdominal preperitoneal hernia repair

  • 期刊论文

  • 发表日期：

    2025年5月23日

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  • Shunsuke Hayakawa,
  • Tetsushi Hayakawa,
  • Kaori Watanabe,
  • Kenta Saito,
  • Hirotaka Miyai,
  • Hiroyuki Sagawa,
  • Ryo Ogawa,
  • Minoru Yamamoto,
  • Kenji Kobayashi,
  • Moritsugu Tanaka,
  • Shuji Takiguchi

摘要

Purpose

This study aimed to develop a classification to precisely describe seroma following transabdominal preperitoneal hernia repair (TAPP) as well as identify risk factors and create a prediction model for seroma development.

Methods

Postoperative seroma was classified into grades 0–IV, with grades ≥ II defined as the seroma group (S group: 265 cases), which was compared with the normal course group (N group: 1,279 cases) to determine risk factors using logistic regression analysis. A prediction model was developed based on these independent predictors. Receiver operating characteristic (ROC) curve analysis was conducted to assess the discriminability and calibrability of the model. Additionally, a model to validate the incidence of seroma was used for risk stratification.

Results

This classification revealed grades 0, I, II, III, and IV in 1,194 (70.9%), 85 (5.5%), 236 (15.3%), 12 (0.8%), and 17 (1.1%) patients, respectively. Multivariate analysis revealed risk factors for seroma formation, including age of > 66 years, American Society of Anesthesiologists scores of ≥ 2, surgery for recurrent hernia, size of hernia defect of > 3 cm, and duration of sickness of > 1 year. The prediction model demonstrated the rates of seroma in the low, moderate, and high score groups of 10.5% (103/984), 23.7% (99/417), and 44.1% (63/143), respectively.

Conclusion

A postoperative complication of TAPP was proposed as a severity classification of seroma. A model to predict the seroma was developed based on the identified risk factors, thereby confirming the possibility of preoperative prediction of the seroma.