Open Emergent Groin Hernia Repair : Anterior or Posterior Approach?
Rodrigues-Gonçalves, V. (Hospital Universitari Vall d'Hebron)
Verdaguer-Tremolosa, M. (Hospital Universitari Vall d'Hebron)
Moratal, M. (Hospital Universitari Vall d'Hebron)
Blanco, R. (Hospital Universitari Vall d'Hebron)
Bravo-Salva, Alejandro (Hospital del Mar (Barcelona, Catalunya))
Pereira-Rodríguez, José Antonio (Hospital del Mar (Barcelona, Catalunya))
López Cano, Manuel (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Introduction: The current literature has not yet provided a definitive conclusion on the best emergency groin hernia repair. The aim of this study was first to compare the short and long-term outcomes between open preperitoneal and anterior approach in emergency groin hernia repair and second to identify risk factors for postoperative complications, mortality, and recurrence. Materials and Methods: This retrospective cohort study included patients who underwent emergency groin hernia repair between January 2010 and December 2018. Short and long-term outcomes were analyzed comparing approach and repair techniques. The predictors of complications and mortality were investigated using multivariate logistic regression. Cox regression multivariate analysis were used to explore risk factors of recurrence. Results: A total of 316 patients met the inclusion criteria. The most widely used surgical techniques were open preperitoneal mesh repair (34%) and mesh plug (34%), followed by Lichtenstein (19%), plug and patch (7%) and tissue repair (6%). Open preperitoneal mesh repair was associated with lower rates of recurrence (p = 0. 02) and associated laparotomies (p < 0. 001). Complication and 90-day mortality rate was similar between the techniques. Multivariable analysis identified patients aged 75 years or older (OR, 2. 08; 95% CI, 1. 14-3. 80; p = 0. 016) and preoperative bowel obstruction (OR, 2. 11; 95% CI, 1. 20-3. 70; p = 0. 010) as risk factors for complications and Comprehensive Complication Index ≥26. 2 as risk factor for 90-day mortality (OR, 44. 76; 95% CI, 4. 51-444. 59; p = 0. 01). Female gender was the only risk factor for recurrence. Conclusion: Open preperitoneal mesh repair may be superior to other techniques in the emergency setting, because it can avoid the morbidity of associated laparotomies, with a lower long-term recurrence rate.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Open preperitoneal hernia repair ; Incarcerated ; Strangulated ; Prosthetic mesh repair ; Emergent groin hernia
Publicat a:	Journal of Abdominal Wall Surgery, Vol. 1 (july 2022) , ISSN 2813-2092

DOI: 10.3389/jaws.2022.10586
PMID: 38314156

12 p, 1.3 MB

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