A study of outcome and complications of emergency inguinal hernias repair
Keywords:Obstructed inguinal hernia, Lichtenstein mesh hernioplasty, Morbidity
Background: Mesh hernioplasty in patients undergoing emergency inguinal hernia repair is considered practically, irrespective of complications. The main aim of this study was to assess the morbidity of Lichtenstein mesh hernioplasty in treating obstructed inguinal hernias. Primary outcome measures were post-operative wound site infection, seroma formation, length of hospital stay, hanging testis, testicular infarct, inguinodynia and recurrence.
Methods: This study was undertaken in the department of General Surgery, SMIMER, Surat, Gujarat, India from August 2016 to July 2019. Fifteen patients were operated and included in the study. All patients underwent standard Lichtenstein mesh hernioplasty for obstracted inguinal hernia repair in emergency operating room.
Results: 5 patients (33%) developed wound site infection, 4 patients (27%) developed inguinodynia, 2 patient (13%) developed seroma formation, 1 patient (6%) developed hanging testis. 1 patient (6%) developed testicular infarct. Average postoperative hospital stay was 5.6 days (range =2-18 days).
Conclusions: Mesh repairs can be safely performed in emergency inguinal hernia repair with acceptable morbidity.
Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362(9395):1561-71.
Dabbas N, Adams K, Pearson K, Royle GT. Frequency of abdominal wall hernias: is classical teaching out of date? JRSM Short Rep. 2011;2(1):5.
EU Hernia Trialists Collaboration. Repair of groin hernia with synthetic mesh: metaanalysis of randomized controlled trials. Ann Surg. 2002;235: 322e32.
Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM. Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev. 2002;(4):CD002197.
Kingsnorth A. Commercial mesh versus Nylon mosquito net for hernia repair. World J Surg. 2007;31:859.
Kulah B, Kulacoglu IH, Oruc MT, Duzgun AP, Moran M, Ozmen MM, et al. Presentation and outcome of incarcerated external hernias in adults. Am J Surg. 2001;181(2):101-4.
Oida T, Kawasaki A, Mimatsu K, Kano H, Kuboi Y, Fukino N, et al. Mesh vs. non-mesh repair for inguinal hernias in emergency operations. Hepatogastroenterol.2012;59(119):2112-4.
Nieuwenhuizen J, Van Ramshorst GH, Ten Brinke JG, de Wit T, van der Harst E, Hop WC, et al. The use of mesh in acute hernia: frequency and outcome in 99 cases. Hernia. 2011;15(3):297-300.
Kark AE, Kurzer M. Groin hernias in women. Hernia. 2008;12(3):267-70.
Ueda J, Nomura T, Sasaki J, Shigehara K, Yamahatsu K, Tani A, et al. Prosthetic repair of an incarcerated groin hernia with small intestinal resection. Surg Today. 2012;42:359-62.
Derici H, Unalp HR, Nazli O, Kamer E, Coskun M, Tansug T, et al. Prosthetic repair of incarcerated inguinal hernias: is it a reliable method? Langenbecks Arch Surg. 2010;395:575-9.
Atila K, Guler S, Inal A, Sokmen S, Karademir S, Bora S. Prosthetic repair of acutely incarcerated groin hernias: a prospective clinical observational cohort study. Langenbecks Arch Surg. 2010;395:563-8.
Adesunkanmi AR, Badmos TA, Salako AA. Groin hernias in patients 50 years of age and above pattern and outcome of management in 250 consecutive patients. West Afr J Med. 2000;19:142-7.
Faridi SH, Aslam M, Ali WM, Siddiqui B, Ahmed NM. A Study of Mesh repair in emergency inguinal hernia surgery. Surg Chron. 2016;21(1):17-20.
Kiss L, Kiss R, Flețan C, Vaida O, Ștefan V, Diaconu EA. Obstructed inguinal hernia: lichtenstein's mesh versus bassini repair technique. Acta Medica Transilvanica. 2014;19(1).
Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endo Other Interven Tech. 2005;19(2):188-99.
Simons MP, Aufenacker T, Bay-Nielsen M. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13:343-403.
Shirah BH, Shirah HA. Lichtenstein mesh hernioplasty for inguinal hernias: simplicity is the ultimate sophistication. Inter Surg J. 2016;3(1):230-6.
Koning GG, Keus F, Koeslag L. Randomized clinical trial of chronic pain after the transinguinal preperitoneal technique compared with Lichtenstein's method for inguinal hernia repair. Br J Surg. 2012;99:1365-73.
Rather AA, Malik AA. Mesh hernioplasty in obstructed inguinal hernia. Inter J Sci Res. 2018;7(6):20-1.