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Piltcher-da-Silva R, Sasaki VL, Bettini LFC, Soares PSM, Valandro IG, Cavazzola LT. Outcomes of Emergency Groin Hernia Repair in the Elderly: A Systematic Review. JOURNAL OF ABDOMINAL WALL SURGERY : JAWS 2023; 2:11246. [PMID: 38312429 PMCID: PMC10831661 DOI: 10.3389/jaws.2023.11246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/01/2023] [Indexed: 02/06/2024]
Abstract
Introduction: The number of surgeries for groin hernia (GH) among the elderly follows the increase in life expectancy of the population. The greater number and severity of comorbidities in this group increases the surgical risk, promoting discussion regarding the indication of elective surgery and the benefits of watchful waiting approach (WWA). The aim of the present study was to evaluate the outcomes of emergency hernia surgery among the elderly population. Materials and methods: A systematic review was performed in Pubmed and Scielo databases for the past early 10 years, until July 2022. The subject was groin hernia in the emergency setting focusing the elderly population. The PRISMA statement was followed and the classification of elderly was based on the World Health Organization's definition. Results: A total of 1,037 results were returned and we ended with nine original articles with emphasis in groin hernia in the emergency among the elderly population. In these subjects, the complications rate ranged between 21.2% and 28.9% and the mortality rate ranged between 1.2% and 6%. Cardiopulmonary disease, high ASA and Charlson's scales were associated with greater risk of complications and death. Conclusion: Emergency GH surgery in the elderly population carries an increased risk of complications and mortality. GH surgery is safe or, at least, less harmful when done electively. The risk and benefits of WWA and upfront surgery needs to be assessed and exposed to the patients. Our review sugest that elective surgery should be the option over WWA in this patient population.
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Affiliation(s)
- Rodrigo Piltcher-da-Silva
- General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Vivian Laís Sasaki
- General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Luiz Francisco Cravo Bettini
- General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Isabelle Garibaldi Valandro
- General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Leandro Totti Cavazzola
- General Surgery Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Patel S, Smiley A, Feingold C, Khandehroo B, Kajmolli A, Latifi R. Chances of Mortality Are 3.5-Times Greater in Elderly Patients with Umbilical Hernia Than in Adult Patients: An Analysis of 21,242 Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10402. [PMID: 36012037 PMCID: PMC9408293 DOI: 10.3390/ijerph191610402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The goal of this study was to identify risk factors that are associated with mortality in adult and elderly patients who were hospitalized for umbilical hernia. A total of 14,752 adult patients (ages 18−64 years) and 6490 elderly patients (ages 65+), who were admitted emergently for umbilical hernia, were included in this retrospective cohort study. The data were gathered from the National Inpatient Sample (NIS) 2005−2014 database. Predictors of mortality were identified via a multivariable logistic regression, in patients who underwent surgery and those who did not for adult and elderly age groups. The mean (SD) ages for adult males and females were 48.95 (9.61) and 46.59 (11.35) years, respectively. The mean (SD) ages for elderly males and females were 73.62 (6.83) and 77.31 (7.98) years, respectively. The overall mortality was low (113 or 0.8%) in the adult group and in the elderly group (179 or 2.8%). In adult patients who underwent operation, age (OR = 1.066, 95% CI: 1.040−1.093, p < 0.001) and gangrene (OR = 5.635, 95% CI: 2.288−13.874, p < 0.001) were the main risk factors associated with mortality. Within the same population, female sex was found to be a protective factor (OR = 0.547, 95% CI: 0.351−0.854, p = 0.008). Of the total adult sample, 43% used private insurance, while only 18% of patients in the deceased population used private insurance. Conversely, within the entire adult population, only about 48% of patients used Medicare, Medicaid, or self-pay, while these patients made up 75% of the deceased group. In the elderly surgical group, the main risk factors significantly associated with mortality were frailty (OR = 1.284, 95% CI: 1.105−1.491, p = 0.001), gangrene (OR = 13.914, 95% CI: 5.074−38.154, p < 0.001), and age (OR = 1.034, 95% CI: 1.011−1.057, p = 0.003). In the adult non-operation group, hospital length of stay (HLOS) was a significant risk factor associated with mortality (OR = 1.077, 95% CI: 1.004−1.155, p = 0.038). In the elderly non-operation group, obstruction was the main risk factor (OR = 4.534, 95% CI: 1.387−14.819, p = 0.012). Elderly patients experienced a 3.5-fold higher mortality than adult patients who were emergently admitted with umbilical hernia. Increasing age was a significant risk factor of mortality within all patient populations. In the adult surgical group, gangrene, Medicare, Medicaid, and self-pay were significant risk factors of mortality and female sex was a significant protective factor. In the adult non-surgical group, HLOS was the main risk factor of mortality. In the elderly population, frailty and gangrene were the main risk factors of mortality within the surgical group, and obstruction was the main risk factor for the non-surgical group.
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Affiliation(s)
- Saral Patel
- Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Abbas Smiley
- Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Cailan Feingold
- Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Bardia Khandehroo
- Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Agon Kajmolli
- Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Rifat Latifi
- Minister of Health, Republic of Kosova, Adjunct Professor of Surgery, University of Arizona, Tucson, AZ 10000, USA
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Ceresoli M, Carissimi F, Nigro A, Fransvea P, Lepre L, Braga M, Costa G. Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry. Hernia 2022; 26:165-175. [PMID: 32737706 PMCID: PMC8881429 DOI: 10.1007/s10029-020-02269-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. METHODS This is a prospective observational study carried out between January 2017 and June 2018 in elderly patients who underwent emergency surgery for complicated hernia in 38 Italian hospitals. Pre-operative, surgical and postoperative data were recorded for each patient. ASA score, Charlson's comorbidity index, P-POSSUM and CR-POSSUM were assessed. RESULTS 259 patients were recruited, mean age was 80 years. A direct repair without mesh was performed in 62 (23.9%) patients. Explorative laparotomy was performed in 56 (21.6%) patients and bowel resection was necessary in 44 (17%). Mortality occurred in seven (2.8%) patients. Fifty-five (21.2%) patients developed complications, 12 of whom had a major one. At univariate and multivariate analyses, Charlson's comorbidity index ≥ 6, altered mental status, and need for laparotomy were associated with major complications and mortality CONCLUSION: Emergency surgery for complicated hernia is burdened by high morbidity and mortality in elderly patients. Preoperative comorbidity played a pivotal role in predicting complications and mortality and therefore Charlson's comorbidity index could be adopted to select patients for elective operation.
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Affiliation(s)
- M Ceresoli
- General and Emergency Surgery Department, School of Medicine and Surgery, University of Milano-Bicocca, via Pergolesi 33, 20900, Monza, Italy.
| | - F Carissimi
- General and Emergency Surgery Department, School of Medicine and Surgery, University of Milano-Bicocca, via Pergolesi 33, 20900, Monza, Italy
| | - A Nigro
- General and Emergency Surgery Department, School of Medicine and Surgery, University of Milano-Bicocca, via Pergolesi 33, 20900, Monza, Italy
| | - P Fransvea
- UOC Chirurgia D'Urgenza E del Trauma, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - L Lepre
- UOC Chirurgia Generale, Ospedale Santo Spirito in Sassia, ASL Roma 1, Roma, Italy
| | - M Braga
- General and Emergency Surgery Department, School of Medicine and Surgery, University of Milano-Bicocca, via Pergolesi 33, 20900, Monza, Italy
| | - G Costa
- Surgical and Medical Department of Translational Medicine, Sant'Andrea Teaching Hospital, Sapienza University of Roma, Roma, Italy
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Tomaoglu K, Okmen H. Prosthetic mesh hernioplasty versus primary repair in incarcerated and strangulated groin and abdominal wall hernias with or without organ resection. Retrospective study. Langenbecks Arch Surg 2021; 406:1651-1657. [PMID: 33733286 DOI: 10.1007/s00423-021-02145-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 03/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The use of synthetic materials in emergency surgery for abdominal wall hernia in a potentially infected operating field has long been debated. In the present study, we evaluated the outcome of mesh prostheses in the management of incarcerated and strangulated abdominal wall hernias with or without organ resection. METHODS Between March 2012 and January 2020, medical records of 301 patients who underwent emergency surgery for incarcerated and strangulated abdominal wall hernias were retrospectively evaluated. The interventions were exclusively realized by two surgical teams, one of which used polypropylene mesh prostheses (group I), whereas the second team performed primary hernia repair (group II). The outcome of patients was observed for a mean follow-up period of 18.2 months. Categorical data were analyzed with the χ2 test or likelihood ratio. Logistic regression was used for adjustments in multivariate analysis. Statistical analyses were realized with SPSS, version 18. P values < 0.05 were considered statistically significant. For multiple comparisons between types of hernia, the significance level was set to P < 0.0083 according to Bonferroni adjustment. RESULTS Of the 301 patients, 190 were men (63.1%), and 111 were women (36.9%). The mean age was 59,98 years (range 17-92). Overall, 226 (75.1%) patients were treated with synthetic mesh replacement. One hundred two organ resections (34%) were performed involving the omentum, small intestine, colon, and appendix. No significant difference was identified in terms of postoperative complications, between the two groups both in patients who underwent organ resection and in patients who did not. CONCLUSION Synthetic materials may safely be used in the emergency management of incarcerated and strangulated groin and abdominal wall hernias in patients with or without organ resection, although they cannot formally be recommended due to the limited number of cases of the present study.
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Affiliation(s)
- Kamer Tomaoglu
- Faculty of Health Sciences, Department of General Surgery, School of Medical Sciences, Esenyurt University, Istanbul, Turkey.
| | - Hasan Okmen
- Department of General Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey
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Chibata M, Daronch OT. Assessment of postoperative risk of complications on inguinal hernioplasty and its relation to risk factors. ACTA ACUST UNITED AC 2020; 66:623-629. [PMID: 32638974 DOI: 10.1590/1806-9282.66.5.623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 12/08/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Abdominal wall hernias are a highly prevalent pathology, considering that 55 percent of the world population is affected by this disease at some point in their lives. As a large part of these patients present comorbidities, it is important to correlate the incidence of complications with the presence of previous pathologies. OBJECTIVES To evaluate whether the presence of comorbidities in patients submitted to inguinal hernioplasty increases the risk of acute and chronic complications in the postoperative period, as well as to explain which of these prior diseases present a greater association with the incidence of complications. METHODS This is a cross-sectional descriptive study carried out through the retrospective analysis of 313 medical records of patients submitted to open inguinal hernioplasty surgery between March and June 2017 at the General Surgery Service of the Cruz Vermelha Hospital - Paraná Branch, located in the City of Curitiba, state of Paraná, Brasil. RESULTS Of the 313 cases studied, the most prevalent comorbidities were: 107 patients with hypertension (34.19%), 52 smokers (16.61%), 30 cases with diabetes (9.58%), 14 with hypothyroidism (4,47%) and 10 with COPD (3.19%). Regarding the total of the sample evaluated, 130 patients (41.53%) did not present any comorbidity. When evaluating the complications, there were 49 cases (15.65%) of complications in the early postoperative period and 9 cases (2.88%) of chronic complications. The comorbidities that presented significant statistical influence (p <0.05) on the incidence of acute complications were hypertension (p = 0.02927) and smoking (p = 0.03196). CONCLUSION It is important to note the presence of acute postoperative complications of inguinal hernioplasty in patients who have hypertension or smoke, high prevalence diseases.
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Chen P, Yang W, Zhang J, Wang C, Yu Y, Wang Y, Yang L, Zhou Z. Analysis of risk factors associated bowel resection in patients with incarcerated groin hernia. Medicine (Baltimore) 2020; 99:e20629. [PMID: 32502042 PMCID: PMC7306359 DOI: 10.1097/md.0000000000020629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Incarcerated groin hernia (IGH) is a common surgical emergency. However, there are few accurate and applicable predictors for differentiating patients with strangulated groin hernia from those with IGH. In this study, we aimed to identify the independent risk factors for bowel resection in patients with IGH. METHODS We retrospectively collected 323 patients who underwent emergency hernia repair surgery for IGH between January 2010 and October 2019. The patients were categorized into those who received bowel resection and those who did not require bowel resection. The receiver-operating characteristic curve was used to identify the best cutoff values for continuous variables. Following this, univariate and multivariate analyses were performed to identify potential risk factors for bowel resection in these patients. RESULTS Univariate analysis identified 6 variables that were significantly associated with bowel resection among patients with IGH. On multivariate analysis, neutrophil-to-lymphocyte ratio (NLR) (odds ratio [OR] = 3.362, 95% confidence interval [CI] 1.705-6.628, P = .000) and bowel obstruction (OR = 3.191, 95% CI 1.873-5.437, P = 0.000) were identified as independent risk factors for bowel resection among patients with IGH. CONCLUSION In this study, an elevated NLR and those with bowel obstruction are associated with an increased risk of bowel resection among patients with IGH. Based on our findings, surgeons should prioritize prompt emergency surgical repair for patients who present with elevated NLR and bowel obstruction concurrent with IGH.
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Affiliation(s)
- Peng Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Wenming Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Jianhao Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Cun Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
- Institute of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu
| | - Yongyang Yu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
- Institute of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu
| | - Yong Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
- Institute of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu
| | - Lie Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
- Institute of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu
- Department of General Surgery, West China-Ziyang Hospital of Sichuan University/The First People's Hospital of Ziyang, Ziyang, Sichuan Province, China
| | - Zongguang Zhou
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
- Institute of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu
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Romano G, Calò PG, Erdas E, Medas F, Gordini L, Podda F, Amato G. Fixation-free incisional hernia repair in the elderly: our experience with a tentacle-shaped implant. Aging Clin Exp Res 2017; 29:173-177. [PMID: 27837460 DOI: 10.1007/s40520-016-0651-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/12/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair. AIMS In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias. The results of a fixation-free incisional hernia repair carried out in elderly patients using a tentacle-shaped implant are reported herewith. METHODS A tentacle-shaped flat mesh with a large central body and integrated arms was used to repair incisional hernia in 23 elderly patients. The mesh was placed fixation-free and secured in place through the friction exerted by the tentacles. All tentacle straps were positioned with a special passer needle. Implant placement was preperitoneal in 18 patients and retromuscular sublay in five. RESULTS In a follow-up of 18 to 59 months (mean 36 months), four seromas occurred. Postoperative fast track helped avoid the typical complications affecting this patient subset. No infection, hematoma, chronic pain, mesh dislocation or recurrence have been reported to date. DISCUSSION The tentacle strap system allowed for reduced skin incision thus minimizing surgical trauma and ensuring easier and faster implant placement. CONCLUSION The tentacle arms of the implant ensured mesh stability and broad defect overlap. Besides a very low complication rate, none of the typical postoperative complications of aged patients occurred.
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Affiliation(s)
- Giorgio Romano
- Department of General Surgery and Emergency, University of Palermo, Palermo, Italy
| | - Pier Giorgio Calò
- Department of General Surgery, University of Cagliari, Cagliari, Italy
| | - Enrico Erdas
- Department of General Surgery, University of Cagliari, Cagliari, Italy
| | - Fabio Medas
- Department of General Surgery, University of Cagliari, Cagliari, Italy
| | - Luca Gordini
- Department of General Surgery, University of Cagliari, Cagliari, Italy
| | - Francesco Podda
- Department of General Surgery, University of Cagliari, Cagliari, Italy
| | - Giuseppe Amato
- Postgraduate School of General Surgery, University of Cagliari, Cagliari, Italy.
- , via M. Rapisardi 66, 90144, Palermo, Italy.
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Combined inguinal hernia in the elderly. Portraying the progression of hernia disease. Int J Surg 2016; 33 Suppl 1:S20-9. [DOI: 10.1016/j.ijsu.2016.05.055] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tatar C, Tüzün İS, Karşıdağ T, Kızılkaya MC, Yılmaz E. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia. Balkan Med J 2016; 33:434-40. [PMID: 27606140 DOI: 10.5152/balkanmedj.2016.150137] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 08/17/2015] [Indexed: 01/28/2023] Open
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 non-complicated 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.
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Affiliation(s)
- Cihad Tatar
- Department of General Surgery, Besni State Hospital, Adıyaman, Turkey
| | - İshak Sefa Tüzün
- Department of General Surgery, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Tamer Karşıdağ
- Department of General Surgery, Ataşehir Memorial Hospital, İstanbul, Turkey
| | | | - Erdem Yılmaz
- Department of General Surgery, Çekirge State Hospital, Bursa, Turkey
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Ferrarese A, Enrico S, Solej M, Surace A, Nardi MJ, Millo P, Allieta R, Feleppa C, D'Ambra L, Berti S, Gelarda E, Borghi F, Pozzo G, Marino B, Marchigiano E, Cumbo P, Bellomo MP, Filippa C, Depaolis P, Nano M, Martino V. Laparoscopic management of non-midline incisional hernia: A multicentric study. Int J Surg 2016; 33 Suppl 1:S108-13. [PMID: 27353846 DOI: 10.1016/j.ijsu.2016.06.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The laparoscopic repair of non-midline ventral hernia (LNM) has been debated. The aim of this study is to analyze our experience performing the laparoscopic approach to non-midline ventral hernias (NMVHs) in Northwest Italy for 6 years. METHODS A total of 78 patients who underwent LNM between March 2008 and March 2014 in the selected institutions were analyzed. We retrospectively analyzed the peri- and postoperative data and the recurrence rate of four subgroups of NMVHs: subcostal, suprapubic, lumbar, and epigastric. We also conducted a literature review. RESULTS No difference was found between the four subgroups in terms of demographic data, defect characteristics, admission data, and complications. Subcostal defects required a shorter operating time. Obesity was found to be a risk factor for recurrence. CONCLUSIONS In our experience, subcostal defects were easier to perform, with a lower recurrence rate, lesser chronic pain, and faster surgical performance. A more specific prospective randomized trial with a larger sample is awaited. Based on our experience, however, the laparoscopic approach is a safe treatment for NMVHs in specialized centers.
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Affiliation(s)
- Alessia Ferrarese
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Torino, Italy.
| | - Stefano Enrico
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Torino, Italy.
| | - Mario Solej
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Torino, Italy.
| | - Alessandra Surace
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Torino, Italy.
| | | | - Paolo Millo
- Hospital "Umberto Parini", Section of General Surgery, Aosta, Italy.
| | - Rosaldo Allieta
- Hospital "Umberto Parini", Section of General Surgery, Aosta, Italy.
| | - Cosimo Feleppa
- Hospital "Sant'Andrea", Section of General Surgery, La Spezia, Italy.
| | - Luigi D'Ambra
- Hospital "Sant'Andrea", Section of General Surgery, La Spezia, Italy.
| | - Stefano Berti
- Hospital "Sant'Andrea", Section of General Surgery, La Spezia, Italy.
| | - Enrico Gelarda
- Hospital "Santa Croce e Carle", Section of General Surgery, Cuneo, Italy.
| | - Felice Borghi
- Hospital "Santa Croce e Carle", Section of General Surgery, Cuneo, Italy.
| | - Gabriele Pozzo
- Hospital "Civile", Section of General Surgery, Asti, Italy.
| | | | - Emma Marchigiano
- Hospital "Santa Croce", Section of General Surgery, Moncalieri, Italy.
| | - Pietro Cumbo
- Hospital "Santa Croce", Section of General Surgery, Moncalieri, Italy.
| | | | - Claudio Filippa
- Hospital "Gradenigo", Section of General Surgery, Torino, Italy.
| | - Paolo Depaolis
- Hospital "Gradenigo", Section of General Surgery, Torino, Italy.
| | - Mario Nano
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Torino, Italy.
| | - Valter Martino
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Torino, Italy.
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Rühling V, Gunnarsson U, Dahlstrand U, Sandblom G. Wound Healing Following Open Groin Hernia Surgery: The Impact of Comorbidity. World J Surg 2015; 39:2392-9. [DOI: 10.1007/s00268-015-3131-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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12
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Affiliation(s)
- Min-Husan Yen
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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Caglià P, Tracia A, Borzì L, Amodeo L, Tracia L, Veroux M, Amodeo C. Incisional hernia in the elderly: Risk factors and clinical considerations. Int J Surg 2014; 12 Suppl 2:S164-S169. [DOI: 10.1016/j.ijsu.2014.08.357] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/15/2014] [Indexed: 01/03/2023]
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Ferrarese A, Marola S, Surace A, Borello A, Bindi M, Cumbo J, Solej M, Enrico S, Nano M, Martino V. Fibrin glue versus stapler fixation in laparoscopic transabdominal inguinal hernia repair: a single center 5-year experience and analysis of the results in the elderly. Int J Surg 2014; 12 Suppl 2:S94-S98. [PMID: 25183643 DOI: 10.1016/j.ijsu.2014.08.371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/15/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Inguinal hernia surgery is one of the most common surgical procedures performed worldwide. Some studies demonstrated clear advantages of laparoscopic approach in terms of chronic pain, recurrence rate and daily life activities Aim of this study was to compare short and long-terms outcome of tacks and fibrin glue used during laparoscopic transabdominal hernioplasty (TAPP). METHODS This is a retrospective study conducted by our division of General Surgery. From May 2008 to May 2013 we performed 116 hernioplasty with TAPP technique. We compared two groups of patients: a group of 59 patients treated with fibrin glue and a group of 57 patients treated with conventional tacks and the two subgroups of patients over 65 years old. We evaluated: perioperative outcomes, early and late complications. RESULTS There were no significative difference about length of postoperative stay, time to return to work, recurrence rate and complications. DISCUSSION This study demonstrates that fibrin glue are same tolerated than tacks by patients and that the glues lead to the same good results during initial follow-up and in long term data also in the elderly. Meticulous preparation of the groin with preservation of spermatic sheet is in our opinion necessary to provide effective pain reduction and a good result in every TAPP procedure.
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Affiliation(s)
- Alessia Ferrarese
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Silvia Marola
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Alessandra Surace
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Alessandro Borello
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Marco Bindi
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Jacopo Cumbo
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Mario Solej
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Stefano Enrico
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Mario Nano
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
| | - Valter Martino
- University of Turin, Department of Oncology, School of Medicine, Teaching Hospital "San Luigi Gonzaga", Section of General Surgery, Orbassano, Turin, Italy.
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