Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias: a 10-year study

• Published in: Hernia : the journal of hernias and abdominal wall surgery 2015-12, Vol.19 (6), p.909-914
• Main Authors: Bessa, S. S., Abdel-fattah, M. R., Al-Sayes, I. A., Korayem, I. T.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Emergencies; Female; Groin - surgery; Hernia, Femoral - surgery; Hernia, Inguinal - surgery; Herniorrhaphy; Humans; Intestinal Obstruction - etiology; Intestinal Obstruction - surgery; Intestine, Small - blood supply; Intestine, Small - pathology; Intestine, Small - surgery; Ischemia - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Polypropylenes; Prospective Studies; Surgical Mesh; Young Adult
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-015-1360-y

Purpose The aim of this prospective study was to present a 10-year experience with the use of prosthetic mesh repair in the management of the acutely incarcerated and/or strangulated groin hernias. Methods Patients with acutely incarcerated and/or strangulated groin hernias were treated by emergency repair of the hernia using a Prolene mesh. The presence of non-viable intestine necessitating resection–anastomosis of the bowel was not considered a contraindication to the use of mesh. Results The present study included 234 patients. Their age ranged from 16 to 85 years with a mean of 55.9 ± 17.7 years. The hernia was indirect inguinal in 201 patients (85.9 %), direct inguinal in 5 patients 5 (2.1 %), hernia of canal of nuck in 13 patients (5.6 %) and femoral in 15 patients (6.4 %). Thirty patients (12.8 %) had recurrent hernias. Resection–anastomosis of non-viable small intestine was performed in 32 patients (13.7 %). There were 5 perioperative mortalities (2.1 %). Complications were encountered in 41 patients (17.5 %) and included wound infection in 14 patients (6 %), scrotal hematoma in 9 patients (3.8 %), chest infection in 8 patients (3.4 %), deep vein thrombosis in 2 patients (0.9 %), transient deterioration of liver function in 11 patients (4.7 %) and mesh infection in 1 patient (0.5 %). Follow-up duration ranged from 6 to 120 months with a mean of 62.5 ± 35.3 months. Two recurrences (0.9 %) were encountered throughout the study period. Conclusions The use of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias is safe. The presence of non-viable intestine cannot be regarded as a contraindication for prosthetic repair.