The results of open preperitoneal prosthetic mesh repair for acutely incarcerated or strangulated inguinal hernia: a retrospective study of 146 cases
Tension-free hernia repair has been regarded as the gold-standard treatment for selected inguinal hernias, but the use of prosthetic mesh in acutely incarcerated or strangulated inguinal hernias is controversial. Our aim was to evaluate the safety and efficacy of open prosthetic mesh repairs for emergency inguinal hernias.
Patients with acutely incarcerated or strangulated inguinal hernias who underwent open preperitoneal prosthetic mesh repairs during 2013 to 2016 at our department were included. Patients’ characteristics, operative details, results, and complications were retrospectively analyzed.
During a 4-year period, 146 cases who met the inclusion criteria were enrolled in our study. There were 127 males and 19 females of median age 75 years (range 19–95 years). The hernia was indirect inguinal in 104 (71.2%) patients, direct inguinal in 18 (12.3%), and femoral hernia in 24 (16.5%). Bowel resection was necessary in 20 patients (13.7%). Complications occurred in 15 (10.3%) patients, including wound infection in 6 (4.1%), scrotal hematoma in 2 (1.4%), bleeding in 1 (0.7%), deep vein thrombosis (DVT) in 2 (1.4%), and chest infection in 4 (2.7%). No mesh-related infections were detected. There were 2 mortalities. During the median follow-up of 26 months (range 6–53 months) 2 recurrences occurred, but there were no deaths or further infections.
Open preperitoneal prosthetic mesh repair can be safely performed in patients with incarcerated or strangulated inguinal hernia without contaminated hernia content. Mesh repair is not contraindicated in patients with bowel resection.
KeywordsIncarcerated Strangulated Inguinal hernia Open preperitoneal mesh repair Prosthetic mesh repair
We thank Hugh McGonigle, from Liwen Bianji, Edanz Group China (http://www.liwenbianji.cn/ac), for editing the English text of a draft of the manuscript.
Compliance with ethical standards
Jing Liu, Yingmo Shen, and Jie Chen have no conflicts of interest or financial ties to disclose.
- 5.Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM (2002) Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev 4:CD002197Google Scholar
- 20.Videhult P, Magnusson J, Thorell A (2009) Low infection risk when using surgical meshes in incarcerated inguinal hernia. Meta-analysis of seven prospective studies with 311 patients. Lakaritidningen 106(36):2218–2220Google Scholar
- 24.D’Ambrosio R, Capasso L, Sgueglia S, Larrobino G, Buonincontro S, Carfora E, Borsi E (2004) The meshes of polypropylene in emergency surgery for strangulated hernias and incisional hernias. Ann Ital Chir 75(5):569–573Google Scholar
- 25.Pach KamtohG.Kibil R, Matyja W, Solecki A, Banans R, Kulig B J (2014) Effectiveness of mesh hernioplasty in incarcerated inguinal hernias. Vidiosurgery 9(3):415–419Google Scholar
- 34.Klinge U, Junge K, Spellerberg B, Piroth C, Klosterhalfen B, Schumpilick V (2002) Do multifilament alloplastic meshes increase the infection rate? Analysis of the polymeric surface, the bacteria adherence, and in vivo consequences in a rat model. J Biomed Mater Res 63(6):765–771CrossRefGoogle Scholar