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Tailored anterior tension-free repair for the treatment of recurrent inguinal hernia previously repaired by anterior approach

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Abstract

Purpose

The purpose of this study is to describe our policy in selecting different types of anaesthesia and anterior tension-free techniques for the repair of recurrent inguinal hernias previously treated by anterior approach and to evaluate early and late outcomes.

Methods

The medical records of 111 patients who underwent recurrent inguinal hernia repair by anterior approach in the period 2000–2013 were reviewed. Fifty patients (45 %) were over 70 years old and 63 (56.7 %) had one or more co-morbidities. Hernias with large defects were the most frequently observed (59.5 %), and no-mesh techniques were the most frequent failed repair (75.7 %). Different anterior tension-free techniques and types of anaesthesia were used, depending on hernia and patient characteristics. Seventy-three patients (65.8 %) were operated on an outpatient basis.

Results

Mean follow-up period was 89 months (range 10–183). No perioperative deaths, medical events, or visceral injuries were recorded. Early postoperative complications occurred in 11 patients: 4 haematomas (3.6 %), 5 seromas (4.5 %), 1 superficial wound infection (0.9 %) and 1 ischemic orchitis (0.9 %). Late complications consisted in 3 cases of chronic moderate pain (3.2 %) and 2 re-recurrences (2.1 %).

Conclusions

Recurrent inguinal hernia previously treated by open anterior technique can be repaired using the same approach, often on an outpatient basis, with a low rate of recurrence and postoperative complications. To be safe and effective, the repair should be performed by appropriately trained surgeons, well versed in the use of different types of anaesthesia and surgical techniques depending on patient and hernia characteristics.

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Authors and Affiliations

  1. Chirurgia Generale A, Policlinico Universitario di Monserrato-AOU di Cagliari, Cagliari, Italy

    E. Erdas, F. Medas, L. Gordini, G. Pisano, A. Nicolosi & P. G. Calò

  2. Chirurgia Generale B, Policlinico Universitario di Monserrato-AOU di Cagliari, Cagliari, Italy

    S. Licheri

  3. Via Mameli, 22, 09124, Cagliari, Italy

    E. Erdas

Authors
  1. E. Erdas
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  2. F. Medas
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  3. L. Gordini
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  4. S. Licheri
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  5. G. Pisano
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  6. A. Nicolosi
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  7. P. G. Calò
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Corresponding author

Correspondence to E. Erdas.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Conflict of interest

EE, FM, LG, SL, GP, AN, and PGC declare that they have no conflict of interest.

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Erdas, E., Medas, F., Gordini, L. et al. Tailored anterior tension-free repair for the treatment of recurrent inguinal hernia previously repaired by anterior approach. Hernia 20, 393–398 (2016). https://doi.org/10.1007/s10029-016-1475-9

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  • DOI: https://doi.org/10.1007/s10029-016-1475-9

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