Advertisement

Langenbeck's Archives of Surgery

, Volume 395, Issue 5, pp 575–579 | Cite as

Prosthetic repair of incarcerated inguinal hernias: is it a reliable method?

  • Hayrullah DericiEmail author
  • Haluk R. Unalp
  • Okay Nazli
  • Erdinc Kamer
  • Murat Coskun
  • Tugrul Tansug
  • Ali D. Bozdag
Original Article

Abstract

Background and aim

It is generally accepted that most inguinal hernias should be operated on electively using synthetic grafts. However, limited information is available on the usage of these materials in patient with incarcerated and strangulated hernias. The objective of this study is to compare the outcomes of incarcerated inguinal hernia repair with or without graft.

Materials and methods

One hundred-thirteen patients with incarcerated inguinal hernia that underwent surgery were included in this study. Patients who underwent Lichtenstein repair were assigned to group I; those who underwent primary repair were assigned to group II. Demographics and characteristics of patients in each group were compared. Chi-square and Student's t-tests were used.

Results

No statistical difference was found between patients who did and did not receive anastomosis in both groups in terms of surgery duration, length of hospital stay, postoperative morbidity, and mortality. Recurrence was found in 4.0% and 20.8% patients in group I and group II, respectively (P = 0.036).

Conclusions

Mesh repair can be preferred in incarcerated inguinal hernia patients because recurrence rate was significantly lower in patients who underwent Lichtenstein repair in this study.

Keywords

Incarcerated inguinal hernia Lichtenstein repair Primary repair Recurrence Graft 

References

  1. 1.
    Gallegos NC, Dawson J, Jarvis M, Hobsley M (1991) Risk of strangulation in groin hernias. Br J Surg 78:1171–1173CrossRefPubMedGoogle Scholar
  2. 2.
    Kulah B, Kulacoglu IH, Oruc MT, Duzgun AP, Moran M, Ozmen MM, Coskun F (2001) Presentation and outcome of incarcerated external hernias in adults. Am J Surg 181:101–104CrossRefPubMedGoogle Scholar
  3. 3.
    Kurt N, Oncel M, Ozkan Z, Bingul S (2003) Risk and outcome of bowel resection in patients with incarcerated groin hernias: retrospective study. World J Surg 27:741–743CrossRefPubMedGoogle Scholar
  4. 4.
    Hetzer FH, Hotz T, Steinke W, Schlumpt R, Decurtins M, Largiader F (1999) Gold standard for inguinal hernia repair: Shouldice or Lichtenstein? Hernia 3:117–120CrossRefGoogle Scholar
  5. 5.
    Nilsson E, Haapaniemi S, Gruber G, Sandblom G (1998) Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996. Br J Surg 85:1686–1691CrossRefPubMedGoogle Scholar
  6. 6.
    Gilbert AI, Graham MF, Voigt WJ (1999) A bilayer patch device for inguinal hernia repair. Hernia 3:161–166CrossRefGoogle Scholar
  7. 7.
    Wysocki A, Kulawik J, Pozniczek M, Strzalka M (2006) Is the Lichtenstein operation of strangulated groin hernia a safe procedure? World J Surg 30:2065–2070CrossRefPubMedGoogle Scholar
  8. 8.
    Pans A, Desaive C, Jacquet N (1997) Use of a preperitoneal prosthesis for strangulated groin hernia. Br J Surg 84:310–312CrossRefPubMedGoogle Scholar
  9. 9.
    Papaziogas B, Lazaridis Ch, Makris J, Koutelidakis J, Patsas A, Grigoriou M, Chatzimavroudis G, Psaralexis K, Atmatzidis K (2005) Tension-free repair versus modified Bassini technique (Andrews technique) for strangulated inguinal hernia: a comparative study. Hernia 9:156–159CrossRefPubMedGoogle Scholar
  10. 10.
    Campanelli G, Nicolosi FM, Pettinari D, Avesani EC (2004) Prosthetic repair, intestinal resection, and potentially contaminated areas: safe and feasible? Hernia 8:190–192CrossRefPubMedGoogle Scholar
  11. 11.
    Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193CrossRefPubMedGoogle Scholar
  12. 12.
    Pavlidis TE, Atmatzidis KS, Lazaridis CN, Papaziogas BT, Makris JG, Papaziogas TB (2002) Comparison between modern mesh and conventional non-mesh methods of inguinal hernia repair. Minerva Chir 57:7–12PubMedGoogle Scholar
  13. 13.
    Zieren J, Zieren HU, Jacobi CA, Wenger FA, Muller JM (1998) Prospective randomized study comparing laparoscopic and open tension-free inguinal hernia repair with Shouldice's operation. Am J Surg 175:330–333CrossRefPubMedGoogle Scholar
  14. 14.
    Mucha P Jr (1987) Small intestinal obstruction. Surg Clin North Am 67:597–620PubMedGoogle Scholar
  15. 15.
    Birolini C, Utiyama EM, Rodrigues AJ Jr, Birolini D (2000) Elective colonic operation and prosthetic repair of incisional hernia: does contamination contraindicate abdominal wall prosthesis use? J Am Coll Surg 191:366–372CrossRefPubMedGoogle Scholar
  16. 16.
    Alvarez JA, Baldonedo RF, Bear IG, Solis JA, Alvarez P, Jorge JI (2004) Incarcerated groin hernias in adults: presentation and outcome. Hernia 8:121–126CrossRefPubMedGoogle Scholar
  17. 17.
    Oishi SN, Page CP, Schwesinger WH (1991) Complicated presentations of groin hernias. Am J Surg 162:568–571CrossRefPubMedGoogle Scholar
  18. 18.
    Andrews NJ (1981) Presentation and outcome of strangulated external hernia in a district general hospital. Br J Surg 68:329–332CrossRefPubMedGoogle Scholar
  19. 19.
    Beets GL, Oosterhuis KJ, Go PM, Baeten CG, Kootstra G (1997) Long-term follow-up (12–15 years) of a randomized controlled trial comparing Bassini–Stetten, Shouldice, and high ligation with narrowing of the internal ring for primary inguinal hernia repair. J Am Coll Surg 185:352–357PubMedGoogle Scholar
  20. 20.
    Melis P, van der Drift DG, Sybrandy R, Go PM (2000) High recurrence rate 12 years after primary inguinal hernia repair. Eur J Surg 166:313–314CrossRefPubMedGoogle Scholar
  21. 21.
    Jees P, Hauge C, Hansen CR (1999) Long-term results of repair of the internal ring for primary inguinal hernia. Eur J Surg 165:748–750CrossRefGoogle Scholar
  22. 22.
    Haapaniemi S, Nilsson E (2002) Recurrence and pain three years after groin hernia repair. Validation of postal questionnaire and selective physical examination as a method of follow-up. Eur J Surg 168:22–28CrossRefPubMedGoogle Scholar
  23. 23.
    Prior MJ, Williams EV, Shukla HS, Phillips S, Vig S, Lewis M (1998) Prospective randomized controlled trial comparing Lichtenstein with modified Bassini repair of inguinal hernia. J R Coll Surg Edinb 43:82–86PubMedGoogle Scholar
  24. 24.
    Mittelstaedt WE, Rodrigues Junior AJ, Duprat J, Bevilaqua RG, Birolini D (1999) Treatment of inguinal hernias. Is the Bassini’s technique yet? A prospective, randomized trial comparing three operative techniques: Bassini, Shouldice and MCVay. Rev Assoc Med Bras 45:105–114CrossRefPubMedGoogle Scholar
  25. 25.
    Muckter H, Reuters G, Vogel W (1994) Bassini and Shouldice repair of inguinal hernia. A retrospective comparative study. Chirurg 65:121–126PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Hayrullah Derici
    • 1
    Email author
  • Haluk R. Unalp
    • 2
  • Okay Nazli
    • 1
  • Erdinc Kamer
    • 2
  • Murat Coskun
    • 1
  • Tugrul Tansug
    • 1
  • Ali D. Bozdag
    • 1
  1. 1.3rd General Surgery ClinicAtaturk Training and Research HospitalIzmirTurkey
  2. 2.4th General Surgery ClinicAtaturk Training and Research HospitalIzmirTurkey

Personalised recommendations