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J Minim Access Surg. 2018 Aug 7. doi: 10.4103/jmas.JMAS_128_18. [Epub ahead of print]

Laparoscopic total extraperitoneal inguinal hernia repair is safe and feasible in patients with continuation of antithrombotics.

Author information

Department of Urology, School of Medicine, College of Medicine; Department of Urology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, Taipei; Department of Urology, Medical College, Tzu Chi University, Hualien, Taiwan.



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.


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.


Laparoscopic TEP inguinal hernia repair can be safely performed in patients with the continuation of their antithrombotic agents in experienced hands.


Anticoagulant; antiplatelet; antithrombotic; inguinal hernia; laparoscopic

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