Hernia

, Volume 18, Issue 3, pp 399–406 | Cite as

Safety of polypropylene mesh for incarcerated groin and obturator hernias: a retrospective study of 110 patients

  • H. Sawayama
  • K. Kanemitsu
  • T. Okuma
  • K. Inoue
  • K. Yamamoto
  • H. Baba
Original Article

Abstract

Purpose

The purpose of this study was to evaluate the mesh repair for an incarcerated groin hernia.

Methods

A total of 110 patients who underwent emergency surgery for incarcerated hernias were retrospectively analyzed using a multivariate analysis.

Results

The postoperative complications were associated with bowel resection, odds ratio (OR) 2.984, and 95 % confidence interval (CI) 1.273 to 6.994. The risk factors for bowel resection were femoral hernia, (OR 5.621, 95 % CI 2.243 to 14.082), and late hospitalization (24 h<), (OR 2.935, 95 % CI 1.163–7.406). The hernias were repaired with mesh in ten of the 39 (25.6 %) patients with bowel resection and sixty-four of the 71 (90.1 %) patients without bowel resection. The complication rate of the patients with bowel resection was 53.8 % and was 26.8 % in those without. The ratios of wound infection were 23.1 and 0.0 %, respectively. Wound infections were detected in two (20 %) of the ten patients who underwent bowel resection with mesh repair; however, there were no patients in whom the mesh was withdrawn due to infection.

Conclusions

No wound infections in patients without bowel resection were detected, and mesh repair could be safely performed. Mesh repair for the patients with bowel resection is not contraindicated, as long as the clean-contamination of the wound was maintained during surgery.

Keywords

Incarcerated groin hernia Mesh repair Bowel resection Wound infection 

Notes

Acknowledgments

The authors are grateful to Drs. Masayuki Watanabe, Seiji Mita, Shinjiro Tomiyasu, Takatsugu Matsumoto, Yuji Yamaguchi, Shinichi Sugiyama, Hideyuki Tanaka, Hironobu Shigaki, and Kensuke Yamamura for their valuable clinical advice. There was no Grant support for the research herein reported.

Conflict of interest

No author has any conflict of interest.

References

  1. 1.
    Bay-Nielsen M, Nilsson E, Nordin P, Kehlet H (2004) Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males. Br J Surg 91(10):1372–1376. doi:10.1002/bjs.4502 PubMedCrossRefGoogle Scholar
  2. 2.
    Kingsnorth AN, Porter CS, Bennett DH, Walker AJ, Hyland ME, Sodergren S (2000) Lichtenstein patch or Perfix plug-and-patch in inguinal hernia: a prospective double-blind randomized controlled trial of short-term outcome. Surgery 127(3):276–283. doi:10.1067/msy.2000.104124 PubMedCrossRefGoogle Scholar
  3. 3.
    Bisgaard T, Bay-Nielsen M, Christensen IJ, Kehlet H (2007) Risk of recurrence 5 years or more after primary Lichtenstein mesh and sutured inguinal hernia repair. Br J Surg 94(8):1038–1040. doi:10.1002/bjs.5756 PubMedCrossRefGoogle Scholar
  4. 4.
    Bisgaard T, Bay-Nielsen M, Kehlet H (2008) Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair. Ann Surg 247(4):707–711. doi:10.1097/SLA.0b013e31816b18e3 PubMedCrossRefGoogle Scholar
  5. 5.
    Adrian Grant PG, Fingerhut Abe, Kingsnorth Andrew, Merello Jesús, O’Dwyer Paddy, Payne John (2002) Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 235(3):322–332CrossRefGoogle Scholar
  6. 6.
    Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157(2):188–193PubMedCrossRefGoogle Scholar
  7. 7.
    Elsebae MM, Nasr M, Said M (2008) Tension-free repair versus Bassini technique for strangulated inguinal hernia: a controlled randomized study. Int J Surg 6(4):302–305. doi:10.1016/j.ijsu.2008.04.006 PubMedCrossRefGoogle Scholar
  8. 8.
    Papaziogas B, Lazaridis C, 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 J Hernias Abdom Wall Surg 9(2):156–159. doi:10.1007/s10029-004-0311-9 CrossRefGoogle Scholar
  9. 9.
    Wysocki A, Kulawik J, Pozniczek M, Strzalka M (2006) Is the Lichtenstein operation of strangulated groin hernia a safe procedure? World J Surg 30(11):2065–2070. doi:10.1007/s00268-005-0416-z PubMedCrossRefGoogle Scholar
  10. 10.
    Bessa SS, Katri KM, Abdel-Salam WN, Abdel-Baki NA (2007) Early results from the use of the Lichtenstein repair in the management of strangulated groin hernia. Hernia J Hernias Abdom Wall Surg 11(3):239–242. doi:10.1007/s10029-007-0207-6 CrossRefGoogle Scholar
  11. 11.
    Atila K, Guler S, Inal A, Sokmen S, Karademir S, Bora S (2010) Prosthetic repair of acutely incarcerated groin hernias: a prospective clinical observational cohort study. Langenbecks Arch Surg 395(5):563–568. doi:10.1007/s00423-008-0414-3 PubMedCrossRefGoogle Scholar
  12. 12.
    Nieuwenhuizen J, van Ramshorst GH, Ten Brinke JG, de Wit T, van der Harst E, Hop WC, Jeekel J, Lange JF (2011) The use of mesh in acute hernia: frequency and outcome in 99 cases. Hernia J Hernias Abdom Wall Surg. doi:10.1007/s10029-010-0779-4 Google Scholar
  13. 13.
    Pans A, Desaive C, Jacquet N (1997) Use of a preperitoneal prosthesis for strangulated groin hernia. Br J Surg 84(3):310–312PubMedCrossRefGoogle Scholar
  14. 14.
    Alvarez JA, Baldonedo RF, Bear IG, Solis JA, Alvarez P, Jorge JI (2004) Incarcerated groin hernias in adults: presentation and outcome. Hernia J Hernias Abdom Wall Surg 8(2):121–126. doi:10.1007/s10029-003-0186-1 CrossRefGoogle Scholar
  15. 15.
    Ge BJ, Huang Q, Liu LM, Bian HP, Fan YZ (2010) Risk factors for bowel resection and outcome in patients with incarcerated groin hernias. Hernia J Hernias Abdom Wall Surg 14(3):259–264. doi:10.1007/s10029-009-0602-2 CrossRefGoogle Scholar
  16. 16.
    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(6):741–743. doi:10.1007/s00268-003-6826-x PubMedCrossRefGoogle Scholar
  17. 17.
    Campanelli G, Nicolosi FM, Pettinari D, Avesani EC (2004) Prosthetic repair, intestinal resection, and potentially contaminated areas: safe and feasible? Hernia J Hernias Abdom Wall Surg 8(3):190–192. doi:10.1007/s10029-004-0242-5 CrossRefGoogle Scholar
  18. 18.
    Yerdel MA, Akin EB, Dolalan S, Turkcapar AG, Pehlivan M, Gecim IE, Kuterdem E (2001) Effect of single-dose prophylactic ampicillin and sulbactam on wound infection after tension-free inguinal hernia repair with polypropylene mesh: the randomized, double-blind, prospective trial. Ann Surg 233(1):26–33PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Dieng M, El Kouzi B, Ka O, Konate I, Cisse M, Sanou A, Sanoussi Y, Dia A, Toure CT (2008) Strangulated groin hernias in adults: a survey of 228 cases. Mali Med 23(1):12–16PubMedGoogle Scholar
  20. 20.
    Haapaniemi S, Gunnarsson U, Nordin P, Nilsson E (2001) Reoperation after recurrent groin hernia repair. Ann Surg 234(1):122–126PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Karatepe O, Adas G, Battal M, Gulcicek OB, Polat Y, Altiok M, Karahan S (2008) The comparison of preperitoneal and Lichtenstein repair for incarcerated groin hernias: a randomised controlled trial. Int J Surg 6(3):189–192. doi:10.1016/j.ijsu.2008.02.007 PubMedCrossRefGoogle Scholar
  22. 22.
    Sgourakis G, Radtke A, Sotiropoulos GC, Dedemadi G, Karaliotas C, Fouzas I, Karaliotas C (2009) Assessment of strangulated content of the spontaneously reduced inguinal hernia via hernia sac laparoscopy: preliminary results of a prospective randomized study. Surg Laparosc Endosc Percutaneous Tech 19(2):133–137. doi:10.1097/SLE.0b013e31819d8b8b CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • H. Sawayama
    • 1
    • 2
  • K. Kanemitsu
    • 2
  • T. Okuma
    • 2
  • K. Inoue
    • 2
  • K. Yamamoto
    • 2
  • H. Baba
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Medical SciencesKumamoto UniversityKumamotoJapan
  2. 2.Department of SurgerySaiseikai Kumamoto HospitalKumamotoJapan

Personalised recommendations