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Prosthetic repair of an incarcerated groin hernia with small intestinal resection

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Abstract

Purpose

No consensus has been reached on the use of prostheses in a potentially infected operating field. In this study, we evaluated the validity of a mesh prosthesis for the repair of incarcerated groin hernias with intestinal resection.

Methods

Twenty-seven patients underwent operations for correction of incarcerated groin hernias with small intestinal resection at our hospital between January 2000 and March 2010. The patients were divided into two groups: those who underwent repair with a prosthetic mesh and those who underwent primary hernia repair. Patients with intestinal perforations, abscess formations, panperitonitis, and those who required colon resections were excluded. The length of the operation, blood loss, and incidences of surgical site infection, postoperative ileus, and recurrence were evaluated in each group.

Results

Of the 27 patients studied, 10 (37%) underwent tension-free repair with a mesh, and 17 (63%) underwent primary hernia repair. Although the patients who underwent primary hernia repair were significantly older than the patients who underwent mesh repair (P = 0.015), no statistically significant differences in morbidity, including surgical site infection, or mortality, were identified.

Conclusion

Strangulated inguinal hernias cannot be considered a contraindication to the use of a prosthetic mesh even in cases requiring small-intestinal resection.

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References

  1. Derici H, Unalp HR, Nazil 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.

    Article  PubMed  Google Scholar 

  2. Pans A, Desive C, Jacquet N. Use of a preperitoneal prosthesis for strangulated groin hernia. Br J Surg. 1997;84:310–2.

    Article  PubMed  CAS  Google Scholar 

  3. Elsebae MMA, Nasr M, Said M. Tension-free repair versus Bassini technique for strangulated inguinal hernia: a controlled randomized study. Int J Surg. 2008;6:302–5.

    Article  PubMed  Google Scholar 

  4. Lohsiriwat V, Sridermma W, Akaraviputh T, Boonnuch W, Chinsawangwatihanakol V, Methasate A, et al. Surgical outcomes of Lichtenstein tension-free hernioplasty for acutely incarcerated inguinal hernia. Surg Today. 2007;37:212–4.

    Article  PubMed  Google Scholar 

  5. Papaziogas B, Lazaridis Ch, Makris J, Koutelidakis J, Patsas A, Grigoriou M, et al. Tension-free repair versus modified Bassini technique (Andrews technique) for strangulated inguinal hernia: a comparative study. Hernia. 2005;9:156–9.

    Article  PubMed  CAS  Google Scholar 

  6. Wysocki A, Pozniczek M, Krzywon J, Strzalka M. Lichtenstein repair for incarcerated groin hernias. Eur J Surg. 2002;168:452–4.

    Article  PubMed  CAS  Google Scholar 

  7. Murai S, Akatsu T, Yabe N, Inoue Y, Akatsu Y. Impacted obturator hernia treated successfully with a Kugel repair: reports of two cases. Surg Today. 2009;39:821–4.

    Article  PubMed  Google Scholar 

  8. Campanelli G, Nicolsi FM, Pettinari D, Avesani EC. Prosthetic repair, intestinal resection, and potentially contaminated areas: safe and feasible? Hernia. 2004;8:190–2.

    Article  PubMed  CAS  Google Scholar 

  9. Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg. 1989;157:188–93.

    Article  PubMed  CAS  Google Scholar 

  10. Read RC. Herniology: past, present, and future. Hernia. 2009;13:577–80.

    Article  PubMed  CAS  Google Scholar 

  11. Kugel RD. Minimally invasive, nonlaparoscopic, preperitoneal, and sutureless, inguinal herniorrhaphy. Am J Surg. 1999;178:298–302.

    Article  PubMed  CAS  Google Scholar 

  12. Wysocki A, Pozniczek M, Krzywon J, Bolt L. Use of polypropylene prostheses for strangulated inguinal and incisional hernia. Hernia. 2001;5:105–6.

    Article  PubMed  CAS  Google Scholar 

  13. Skandalakis PN, Zoras O, Skandalakis J, Mirilas P. Richter hernia surgical anatomy and technique of repair. Am Surg. 2006;72:180–4.

    PubMed  Google Scholar 

  14. Fawole AS, Chaparala RP, Ambrose NS. Fate of the inguinal hernia following removal of infected prosthetic mesh. Hernia. 2006;10:58–61.

    Article  PubMed  CAS  Google Scholar 

  15. Shulman AG, Amid PK, Lichtenstein IL. The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources. Am Surg. 1992;58:255–7.

    PubMed  CAS  Google Scholar 

  16. Taylor SG, O’Dwyer PJ. Chronic groin sepsis following tension-free inguinal hernioplasty. Br J Surg. 1999;86:562–5.

    Article  PubMed  CAS  Google Scholar 

  17. Yerdel MA, Akin EB, Dolalan S, Turkcapar AG, Pehlivan M, Gecim IE, et al. 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. 2001;233:26–33.

    Article  PubMed  CAS  Google Scholar 

  18. Ismail W, Agrawal A, Zia MI. Fate of chronically infected onlay mesh in groin wound. Hernia. 2002;6:79–81.

    Article  PubMed  CAS  Google Scholar 

  19. Hatada T, Ishii H, Ichii S, Ashida H, Yamamura T. Late infection after mesh-plug inguinal hernioplasty. Am J Surg. 2000;179:76–7.

    Article  PubMed  CAS  Google Scholar 

  20. Buret A, Ward KH, Olson ME, Costerton JW. An in vivo model to study the pathobiology of infectious biofilms on biomaterial surfaces. J Biomed Mater Res. 1991;25:865–74.

    Article  PubMed  CAS  Google Scholar 

  21. Gristina AG, Costerton JW. Bacterial adherence to biomaterials and tissue. The significance of its role in clinical sepsis. J Bone Joint Surg. 1985;67:264–73.

    PubMed  CAS  Google Scholar 

  22. Gilbert AI, Felton LL. Infection in inguinal hernia repair, considering biomaterials and antibiotics. Surg Gynecol Obstet. 1993;177:126–30.

    PubMed  CAS  Google Scholar 

  23. Praveen S, Rohaizak M. Local antibiotics are equivalent to intravenous antibiotics in the prevention of superficial wound infection in inguinal hernioplasty. Asian J Surg. 2009;32:59–63.

    Article  PubMed  CAS  Google Scholar 

  24. Pessaux P, Lermite E, Blezel E, Msika S, Hay JM, Flamamt Y, et al. Predictive risk score for infection after inguinal hernia repair. Am J Surg. 2006;192:165–71.

    Article  PubMed  Google Scholar 

  25. Schwab R, Walters CA, Weksler ME. Host defense mechanisms and aging. Semin Oncol. 1989;16:20–7.

    PubMed  CAS  Google Scholar 

  26. Gardner ID. The effect of aging on susceptibility to infection. Rev Infect Dis. 1980;2:801–10.

    Article  PubMed  CAS  Google Scholar 

  27. Armstrong M. Obesity as an intrinsic factor affecting wound healing. J Wound Care. 1998;7:220–1.

    PubMed  CAS  Google Scholar 

  28. Moro ML, Carrieri MP, Tozzi AE, Lana S, Greco D. Risk factors for surgical wound infections in clean surgery: a multicenter study. Italian PRINOS Study Group. Ann Ital Chir. 1996;67:13–9.

    PubMed  CAS  Google Scholar 

  29. Gokula RR, Hickner JA, Smith MA. Inappropriate use of urinary catheters in elderly patients at a midwestern community teaching hospital. Am J Infect Control. 2004;32:196–9.

    Article  PubMed  Google Scholar 

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Conflict of interest

Junji Ueda and all co-authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Junji Ueda, Tsutomu Nomura, Junpei Sasaki, Kengo Shigehara, Kazuya Yamahatsu, Aya Tani, Kiyonori Furukawa & Eiji Uchida

  2. Department of Surgery, Shioda Hospital, Chiba, Japan

    Yoshinobu Shioda

Authors
  1. Junji Ueda
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  2. Tsutomu Nomura
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  3. Junpei Sasaki
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  4. Kengo Shigehara
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  5. Kazuya Yamahatsu
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  6. Aya Tani
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  7. Yoshinobu Shioda
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  8. Kiyonori Furukawa
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  9. Eiji Uchida
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Correspondence to Junji Ueda.

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Ueda, J., Nomura, T., Sasaki, J. et al. Prosthetic repair of an incarcerated groin hernia with small intestinal resection. Surg Today 42, 359–362 (2012). https://doi.org/10.1007/s00595-011-0019-2

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  • DOI: https://doi.org/10.1007/s00595-011-0019-2

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