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Published in: Surgical Endoscopy 1/2023

23-08-2022 | Femoral Hernia | Original Article

Comparison of mesh repair and suture repair for the treatment of incarcerated femoral hernia: a retrospective, single-center study

Authors: Jianfang Li, Changfu Qin, Yueming Hu

Published in: Surgical Endoscopy | Issue 1/2023

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Abstract

Background

Femoral hernias often present with incarceration or strangulation that requires emergency surgery. However, recommendations vary regarding optimal approaches for incarcerated femoral hernia. The aim of this study is to compare clinical efficacy between mesh repair and suture repair for the treatment of incarcerated femoral hernia.

Methods

Retrospective, single-center analysis of the clinical data from 48 patients with incarcerated femoral hernia, including 16 patients who underwent mesh repair (mesh repair group) and 32 patients who underwent traditional suture repair (suture repair group).

Results

The mean age, body mass index, incarceration duration, hernia sac size, operation duration, and the rates of postoperative incision infection, recurrence, chronic pain, and mortality were not significantly different between the suture repair and mesh repair groups (P > 0.05 for all). In contrast, the female/male ratio; the rates of bowel obstruction, coexisting diseases, and nighttime operation; and the American Society of Anesthesiologists grade were higher and the rate of prophylactic antibiotic use and the mean cost of hospitalization were lower in the suture repair group than in the mesh repair group (P < 0.05 for all).

Conclusion

The surgical approach should be chosen based on the patient’s condition. Mesh repair for the emergency treatment of incarcerated femoral hernia is safe and effective, whereas suture repair is suitable for elderly patients, those with more coexisting diseases, and those with limited life expectancy.
Literature
1.
go back to reference HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef
2.
go back to reference Bay-Nielsen M, Kehlet H, Strand L, Malmstrøm J, Andersen FH, Wara P, Juul P, Callesen T, Collaboration DHD (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128CrossRef Bay-Nielsen M, Kehlet H, Strand L, Malmstrøm J, Andersen FH, Wara P, Juul P, Callesen T, Collaboration DHD (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128CrossRef
3.
go back to reference Mikkelsen T, Bay-Nielsen M, Kehlet H (2002) Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg 89:486–488CrossRef Mikkelsen T, Bay-Nielsen M, Kehlet H (2002) Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg 89:486–488CrossRef
4.
go back to reference Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G, Sahin M (2006) Femoral hernia: a review of 83 cases. Hernia 10:70–73CrossRef Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G, Sahin M (2006) Femoral hernia: a review of 83 cases. Hernia 10:70–73CrossRef
5.
go back to reference Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U (2009) Emergency femoral hernia repair: a study based on a national register. Ann Surg 249:672–676CrossRef Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U (2009) Emergency femoral hernia repair: a study based on a national register. Ann Surg 249:672–676CrossRef
6.
go back to reference Jiang XM, Sun RX, Huang WH, Yu JP (2019) Midline preperitoneal repair for incarcerated and strangulated femoral hernia. Hernia 23:323–328CrossRef Jiang XM, Sun RX, Huang WH, Yu JP (2019) Midline preperitoneal repair for incarcerated and strangulated femoral hernia. Hernia 23:323–328CrossRef
7.
go back to reference Aranovich D, Zilbermints V, Kaminsky O (2018) Incarcerated femoral hernia repair with Ventralex™ hernia patch through same skin incision and suprainguinal laparotomy. Case Rep Surg 2018:9719310 Aranovich D, Zilbermints V, Kaminsky O (2018) Incarcerated femoral hernia repair with Ventralex™ hernia patch through same skin incision and suprainguinal laparotomy. Case Rep Surg 2018:9719310
8.
go back to reference Lin YT, Weng TY, Tam KW (2020) Effectiveness and safety of mesh repair for incarcerated or strangulated hernias: a systematic review and meta-analysis. World J Surg 44:2176–2184CrossRef Lin YT, Weng TY, Tam KW (2020) Effectiveness and safety of mesh repair for incarcerated or strangulated hernias: a systematic review and meta-analysis. World J Surg 44:2176–2184CrossRef
9.
go back to reference Duan SJ, Qiu SB, Ding NY, Liu HS, Zhang NS, Wei YT (2018) Prosthetic mesh repair in the emergency management of acutely strangulated groin hernias with Grade I bowel necrosis: a rational choice. Am Surg 84:215–219CrossRef Duan SJ, Qiu SB, Ding NY, Liu HS, Zhang NS, Wei YT (2018) Prosthetic mesh repair in the emergency management of acutely strangulated groin hernias with Grade I bowel necrosis: a rational choice. Am Surg 84:215–219CrossRef
10.
go back to reference Tomaoglu K, Okmen H (2021) 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 406:1651–1657CrossRef Tomaoglu K, Okmen H (2021) 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 406:1651–1657CrossRef
11.
go back to reference Ninomiya S, Fujita S, Ogawa T, Ueda Y, Shiraishi N, Inomata M, Shimoda K (2020) Incarcerated femoral hernia treated with elective totally extraperitoneal repair: a case report. J Surg Case Rep 2020:rjaa158CrossRef Ninomiya S, Fujita S, Ogawa T, Ueda Y, Shiraishi N, Inomata M, Shimoda K (2020) Incarcerated femoral hernia treated with elective totally extraperitoneal repair: a case report. J Surg Case Rep 2020:rjaa158CrossRef
12.
go back to reference Kim G, Yan So JBY, Shabbir A (2017) Totally extra-peritoneal repair for acute incarcerated femoral hernia with intestinal obstruction. Int J Surg Case Rep 32:16–18CrossRef Kim G, Yan So JBY, Shabbir A (2017) Totally extra-peritoneal repair for acute incarcerated femoral hernia with intestinal obstruction. Int J Surg Case Rep 32:16–18CrossRef
13.
go back to reference Pillay Y (2015) Laparoscopic repair of an incarcerated femoral hernia. Int J Surg Case Rep 17:85–88CrossRef Pillay Y (2015) Laparoscopic repair of an incarcerated femoral hernia. Int J Surg Case Rep 17:85–88CrossRef
14.
go back to reference Glassow F (1985) Femoral hernia. Review of 2,105 repairs in a 17 year period. Am J Surg 150:353–356CrossRef Glassow F (1985) Femoral hernia. Review of 2,105 repairs in a 17 year period. Am J Surg 150:353–356CrossRef
15.
go back to reference Naude GP, Ocon S, Bongard F (1997) Femoral hernia: the dire consequences of a missed diagnosis. Am J Emerg Med 15:680–682CrossRef Naude GP, Ocon S, Bongard F (1997) Femoral hernia: the dire consequences of a missed diagnosis. Am J Emerg Med 15:680–682CrossRef
16.
go back to reference Jones RA (1966) Femoral hernia following inguinal hernioplasty. Am Surg 32:725–732 Jones RA (1966) Femoral hernia following inguinal hernioplasty. Am Surg 32:725–732
17.
go back to reference Okazaki R, Poudel S, Hane Y, Saito T, Muto J, Syoji Y, Hase R, Senmaru N, Hirano S (2021) Laparoscopic approach as a safe and effective option for incarcerated femoral hernias. Asian J Endosc Surg 15:328–334CrossRef Okazaki R, Poudel S, Hane Y, Saito T, Muto J, Syoji Y, Hase R, Senmaru N, Hirano S (2021) Laparoscopic approach as a safe and effective option for incarcerated femoral hernias. Asian J Endosc Surg 15:328–334CrossRef
18.
go back to reference Bittner RR, Felix EL (2021) History of inguinal hernia repair, laparoendoscopic techniques, implementation in surgical praxis, and future perspectives: considerations of two pioneers. Int J Abdom Wall Hernia Surg 4:133–155 Bittner RR, Felix EL (2021) History of inguinal hernia repair, laparoendoscopic techniques, implementation in surgical praxis, and future perspectives: considerations of two pioneers. Int J Abdom Wall Hernia Surg 4:133–155
19.
go back to reference Tsuchiya Y, Momose H, Kure K, Ro H, Takahashi R, Okazawa Y, Kawai M, Takahashi M, Kojima Y, Sakamoto K (2021) Case of incarcerated femoral hernia treated with laparoscopic surgery after groin hernia repair. Case Rep Gastroenterol 15:35–40CrossRef Tsuchiya Y, Momose H, Kure K, Ro H, Takahashi R, Okazawa Y, Kawai M, Takahashi M, Kojima Y, Sakamoto K (2021) Case of incarcerated femoral hernia treated with laparoscopic surgery after groin hernia repair. Case Rep Gastroenterol 15:35–40CrossRef
20.
go back to reference Bittner JG (2016) Incarcerated/strangulated hernia: open or laparoscopic? Adv Surg 50:67–78CrossRef Bittner JG (2016) Incarcerated/strangulated hernia: open or laparoscopic? Adv Surg 50:67–78CrossRef
Metadata
Title
Comparison of mesh repair and suture repair for the treatment of incarcerated femoral hernia: a retrospective, single-center study
Authors
Jianfang Li
Changfu Qin
Yueming Hu
Publication date
23-08-2022
Publisher
Springer US
Keyword
Femoral Hernia
Published in
Surgical Endoscopy / Issue 1/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-022-09488-0

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