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09-09-2022 | Laparotomy | Original Article

Open preperitoneal vs. open anterior repair for the treatment of emergency femoral hernia: a bicentric retrospective study

Authors: V. Rodrigues-Gonçalves, M. Verdaguer, A. Bravo-Salva, M. Moratal, R. Blanco, F. Ochoa-Segarra, J. A. Pereira-Rodríguez, M. López-Cano

Published in: Hernia | Issue 1/2023

Abstract

Purpose

The aim of this study is to compare the postoperative results, in terms of complications and recurrence, between the anterior and open preperitoneal approaches in emergency femoral hernia.

Methods

This bi-centric retrospective cohort study included patients who underwent emergency femoral hernia repair between January 2010 and December 2018. Postoperative complications and recurrence were analyzed comparing anterior and open preperitoneal approaches. The predictors of complications, mortality and recurrence were investigated using multivariate logistic regression.

Results

A total of 204 patients met the inclusion criteria. Open anterior approach was performed in 128 (62.7%) patients and open preperitoneal was performed in 76 (37.3%). Open preperitoneal approach was associated with lower rates of recurrence (P = 0.033) and associated midline laparotomies (P = 0.006). Multivariable analysis identified patients with chronic nephropathy (OR, 3.801; 95%CI, 1.034–13.974; P = 0.044), preoperative bowel obstruction (OR, 2.376; 95%CI, 1.118–5.047; P = 0.024) and required midline laparotomy (OR, 12.467; 95%CI, 11.392–102.372; P = 0.030) as risk factors for complications and ASA ≥ III (OR, 7.820; 95%CI, 1.279–47.804; P = 0.026), COPD (OR, 5.064; 95%CI, 1.188–21.585; P = 0.028), necrotic contents (OR, 36.968; 95%CI, 4.640–294.543; P = 0.001), and required midline laparotomy (OR, 11.047; 95%CI, 1.943–62.809; P = 0.007). as risk factors for 90-day mortality. Male gender (OR, 4.718; 95%CI, 1.668–13.347; P = 0.003) and anterior approach (OR, 5.292; 95%CI, 1.114–25.149; P = 0.036) were risk factors for recurrence.

Conclusion

Open preperitoneal approach may be superior to anterior approach in the emergency setting because it can avoid the morbidity of associated midline laparotomies, with a lower long-term recurrence rate.

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Title: Open preperitoneal vs. open anterior repair for the treatment of emergency femoral hernia: a bicentric retrospective study
Authors: V. Rodrigues-Gonçalves
M. Verdaguer
A. Bravo-Salva
M. Moratal
R. Blanco
F. Ochoa-Segarra
J. A. Pereira-Rodríguez
M. López-Cano
Publication date: 09-09-2022
Publisher: Springer Paris
Keywords: Laparotomy
Laparotomy
Femoral Hernia
Published in: Hernia / Issue 1/2023
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-022-02673-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Open preperitoneal vs. open anterior repair for the treatment of emergency femoral hernia: a bicentric retrospective study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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