Examination of pseudorecurrence cases after inguinal hernia surgery

INTRODUCTION: Recurrence is a significant health concern following inguinal hernia surgery, and pseudo-recurrence is another significant problem among recurrence cases. This retrospective multicenter study aimed to examine pseudo-recurrence and its characteristics after laparoscopic inguinal hernia surgery.
METHODS: Patients who underwent inguinal hernia surgery using the Transabdominal Preperitoneal Procedure (TAPP) and Total Extraperitoneal Procedure (TEP) procedures at various centers between 2007 and 2020 were included. Patient details, including gender, age, unilateral and bilateral sides, type of surgery, and postoperative diagnostic parameters, were obtained.
RESULTS: Age mean of pseudo-recurrence patients was 62.58±10.34 with 32-75 range. For inguinal hernia patients, age range was 20 to 89 with 52.14±13.29 mean value. Age difference between inguinal hernia and pseudo-recurrence patients were statistically significant (p<0.05). All pseudo-recurrence patients were males, and 95.7% of inguinal hernia patients were males. Gender differences were insignificant as below 5% percentage (p<0.05). 77.0% of inguinal hernia, 78.9% of pseudo-recurrence patients had unilateral diagnosis, and differences were statistically insignificant (p>0.05). 8.6% of TAPP patients and 5.9% of TEPP patients were pseudo-recurrence, and differences were statistically insignificant (p>0.05). All pseudo-recurrence patients were males, and only 4 of patients had unilateral diagnosis. Nine patients in TAPP procedure included five aspiration hematoma, one cord lipoma, and three aspiration seroma cases. Ten patients in TEP procedure included six aspiration hematoma, three aspiration seroma and one cord lipoma. Ages were ranged from 32 to 75.
DISCUSSION AND CONCLUSION: Pseudo-recurrence is highly prevalent in both TAPP and TEP procedures, creating unnecessary invasive procedures for patients and a significant burden on the healthcare system. Therefore, further clinical research and studies are needed to identify and treat pseudo-recurrences in inguinal hernia surgery using medical or other methods before surgery.