Purpose: The purpose of this study is to describe our policy in selecting different types of anaesthesia and anterior tension-free techniques for the repair of recurrent inguinal hernias previously treated by anterior approach and to evaluate early and late outcomes. Methods: The medical records of 111 patients who underwent recurrent inguinal hernia repair by anterior approach in the period 2000–2013 were reviewed. Fifty patients (45 %) were over 70 years old and 63 (56.7 %) had one or more co-morbidities. Hernias with large defects were the most frequently observed (59.5 %), and no-mesh techniques were the most frequent failed repair (75.7 %). Different anterior tension-free techniques and types of anaesthesia were used, depending on hernia and patient characteristics. Seventy-three patients (65.8 %) were operated on an outpatient basis. Results: Mean follow-up period was 89 months (range 10–183). No perioperative deaths, medical events, or visceral injuries were recorded. Early postoperative complications occurred in 11 patients: 4 haematomas (3.6 %), 5 seromas (4.5 %), 1 superficial wound infection (0.9 %) and 1 ischemic orchitis (0.9 %). Late complications consisted in 3 cases of chronic moderate pain (3.2 %) and 2 re-recurrences (2.1 %). Conclusions: Recurrent inguinal hernia previously treated by open anterior technique can be repaired using the same approach, often on an outpatient basis, with a low rate of recurrence and postoperative complications. To be safe and effective, the repair should be performed by appropriately trained surgeons, well versed in the use of different types of anaesthesia and surgical techniques depending on patient and hernia characteristics

Tailored anterior tension-free repair for the treatment of recurrent inguinal hernia previously repaired by anterior approach

ERDAS, ENRICO;MEDAS, FABIO;GORDINI, LUCA;PISANO, GIUSEPPE;NICOLOSI, ANGELO;CALO', PIETRO GIORGIO
2016

Abstract

Purpose: The purpose of this study is to describe our policy in selecting different types of anaesthesia and anterior tension-free techniques for the repair of recurrent inguinal hernias previously treated by anterior approach and to evaluate early and late outcomes. Methods: The medical records of 111 patients who underwent recurrent inguinal hernia repair by anterior approach in the period 2000–2013 were reviewed. Fifty patients (45 %) were over 70 years old and 63 (56.7 %) had one or more co-morbidities. Hernias with large defects were the most frequently observed (59.5 %), and no-mesh techniques were the most frequent failed repair (75.7 %). Different anterior tension-free techniques and types of anaesthesia were used, depending on hernia and patient characteristics. Seventy-three patients (65.8 %) were operated on an outpatient basis. Results: Mean follow-up period was 89 months (range 10–183). No perioperative deaths, medical events, or visceral injuries were recorded. Early postoperative complications occurred in 11 patients: 4 haematomas (3.6 %), 5 seromas (4.5 %), 1 superficial wound infection (0.9 %) and 1 ischemic orchitis (0.9 %). Late complications consisted in 3 cases of chronic moderate pain (3.2 %) and 2 re-recurrences (2.1 %). Conclusions: Recurrent inguinal hernia previously treated by open anterior technique can be repaired using the same approach, often on an outpatient basis, with a low rate of recurrence and postoperative complications. To be safe and effective, the repair should be performed by appropriately trained surgeons, well versed in the use of different types of anaesthesia and surgical techniques depending on patient and hernia characteristics
File in questo prodotto:
File Dimensione Formato  
Tailored anterior tension-free repair for the treatment of recurrent inguinal hernia previously repaired by.pdf

Solo gestori archivio

Tipologia: versione editoriale
Dimensione 365.25 kB
Formato Adobe PDF
365.25 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11584/146339
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 3
social impact