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Goni Moreno progressive preoperative pneumoperitoneum for giant hernias: a monocentric retrospective study of 162 patients

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Abstract

Introduction

Goni Moreno’s procedure was described 60 years ago as a solution for giant hernias repair through the creation of a progressive preoperative pneumoperitoneum (PPP). The main objective of the present study is to assess its effectiveness in terms of primary fascial closures. The secondary objectives of this study are to explore the morbidity and mortality associated with Moreno’s procedure using 40 years of data from a large cohort of patients.

Materials and methods

This is a retrospective study of all patients who underwent PPP procedures between October 1974 and January 2019 at the digestive surgery unit at Grenoble University Hospital, France. Data were reviewed to assess the preoperative demographic characteristics of the patients, procedure, postoperative course, complication following Clavien–Dindo classification and 30-day outcomes.

Results

162 procedures were attempted. The mean age of patients was 57.8 years. 83 patients had a history of chronic respiratory disease (51.2%). The mean BMI was 33.2 kg/m2, and 52 patients were obese (32.1%) Half of the patients were classified as ASA score III. Success rate of fascial closures was 95.7%. The global rate of complication during the insufflation period and after surgical repair of the hernia was 51.8% (n = 84). Among these, only 16.7% (n = 27) were major according to the Clavien–Dindo classification. The global mortality rate was 3.1%.

Conclusion

Goni Moreno PPP is an effective procedure that allows a high rate of fascial closure. The population of patients requiring such procedures presents a high-risk profile for complications regarding demographics and associated diseases.

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Authors and Affiliations

  1. Department of Digestive Surgery, Grenoble Alpes University Hospital, CS 10 217, 38 043, Grenoble Cedex, France

    A. Mancini, N. Mougin, V. Venchiarutti, Z. Shen, O. Risse, J. Abba & C. Arvieux

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  1. A. Mancini
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  2. N. Mougin
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  3. V. Venchiarutti
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  4. Z. Shen
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  5. O. Risse
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  6. J. Abba
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  7. C. Arvieux
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Correspondence to C. Arvieux.

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The authors declare that they have no conflict of interest.

Ethical approval

In accordance with the law on medical research in our country concerning retrospective and non-interventional study, all patients have received a written information on the study and have had the opportunity to refuse to participate. The whole study and protocol were approved by a local ethic committee.

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The study including human participants has been performed in accordance with the ethical standards of the declaration of Helsinki and its later amendments.

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For this retrospective review, formal consent is not required.

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Mancini, A., Mougin, N., Venchiarutti, V. et al. Goni Moreno progressive preoperative pneumoperitoneum for giant hernias: a monocentric retrospective study of 162 patients. Hernia 24, 545–550 (2020). https://doi.org/10.1007/s10029-019-02113-5

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  • DOI: https://doi.org/10.1007/s10029-019-02113-5

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