Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

Abstract

Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of noncomplicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3), and the other consisting of patients not undergoing bowel resection (Group 4). Results: In Group 1, it was observed that eight (7.14%) of the patients had wound infections, while two (1.78%) had hematomas, four (3.57%) had seromas, and one (0.89%) had relapse. In Group 2, one (2.56%) of the patients had a wound infection, while three (7.69%) had hematomas, one (2.56%) had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection, seroma, hematoma, or relapse (p>0.05). In Group 3, it was observed that one (6.7%) of the patients had wound infections, while one (6.7%) had a hematoma, one patient (6.7%) had seroma, and none had relapses. In Group 4, seven (7.2%) of the patients had wound infections, while one (1%) had a hematoma, three (3%) had seromas, and one (1%) had a relapse. There were no significant differences between the two groups with respect to wound infection, seroma, hematoma, or relapse (p>0.05). Conclusion: In urgent groin hernia repair surgeries, polypropylene mesh can be safely used even in the patients undergoing bowel resection.

Keywords

• Incarcerated, inguinal hernia, prosthetic mesh

Kaynakça

1. 1. Skandalakis LJ, GadaczTR, Mansberger AR, Mitchell WE, Colborn GL, Skandalakis JE, Çeviri: Dr. Ünal Değerli: Modern Herni Tamiri 2002;1:3-250.
2. 2. Lichtenstein IL, Shore JM. Simplified repair of femoral and reccurent inguinal hernia by a “plug” Technigue. Arm J Surg 1974;128:439-56. [Crossref]
3. 3. Velitchkov NG, Losanoff JE, Kiossev KT, Grigorov GI, Kirov GK, Losanoff CE. The Lichtenstein open tension-free inguinal hernia repair using a new prosthetic mesh-Bulgarian irresorbableampoxen. Int Surg 1996;81:205-9.
4. 4. Papaziogas B, Lazaridis C, Makris J, Koutelidakis J, Patsas A, Grigoriou M, et al. Tension-free repair versus modified Bassini technique (Andrews technique) for strangulated inguinal hernia: a com-parative study. Hernia 2005;9:156-9. [Crossref]
5. 5. Noszczyk W, Szmidt J. ChirurgiaOgo´lna. In W. Noszczyk, O chirurgiipolskiejkon´ca XX wieku. Warszawa FundacjaPolskiPrzegla˛ d Chirurgiczny 2001;52-69.
6. 6. Haapaniemi S, Gunnarsson U, Nordin P, Nisson E. Reoperation after recurrent hernia repair. Ann Surg 2001;234:122-6. [Crossref]
7. 7. Petersen S, Henke G, Freitag M, Faulhaber A, Ludwig K. Deep prosthesis infection in incisional hernia repair: predictive factors and clinical outcome. Eur J Surg 2001;167:453-7. [Crossref]
8. 8. Amid PK. Classification of biomaterials and their related complications in abdominal wall hernia surgery. Hernia 1997;1:15- 21. [Crossref]

9. 9. Pavlidis TE, Atmatzidis KS, Lazaridis CN, Papaziogas BT, Makris JG, Papaziogas TB. Comparison between mod-ern mesh and conventional non-mesh methods of inguinal hernia repair. Minerva Chir 2002;57:7-12.
10. 10. Zieren J, Zieren HU, Jacobe CA, Wenger FA, Müller JM. Prospective randomized study comparing laparoscopic and open tension-free inguinal hernia repair with Shouldice’s operation. Am J Surg 1998;175:330-3. [Crossref]
11. 11. Catena F, La Donna M, Gagliardi S, Mingolla P, Avanzolini A, Pasgualini E, et al. Use of prosthetic mesh in complicated incisional hernias. Minerva Chir 2002;57:363-9.