Clinical efficacy of mesh repair via inguinal approach in acute femoral hernia / 中华消化外科杂志

ABSTRACT

Objective To investigate the clinical efficacy of mesh repair via inguinal approach in acute femoral hernia.Methods The retrospective cohort study was conducted.The clinical data of 48 patients with acute femoral hernia who were admitted to Huadong Hospital Affiliated to Fudan University between January 2007 and December 2016 were collected.Of 48 patients,29 undergoing hernia repair with polypropylene mesh and 19 undergoing hernia repair with suture were allocated into the study group and control group respectively.All the patients underwent hernia repair via inguinal approach.Observation indicators(1) surgical and postoperative situations;(2) follow-up and survival situations.Follow-up was performed by outpatient examination and telephone interview to detect complications,hernia recurrence,survival situations at 1-,3-month and 1 year postoperatively for 1 year up to December 2017.Measurement data with normal distribution were represent as x±s and comparison between groups was done by the t test.Comparison of count data was analyzed using the chi-square test or Fisher exact probability.Results (1) Surgical and postoperative situationspatients in the 2 groups underwent successful incarcerated or strangulated acute femoral hernia repair.There were 3 and 4 patients receiving small bowel resection in the study group and control group respectively,with no statistically significant difference between groups (x2=1.50,P＞0.05).The operation time was respectively (82±16)minutes and (96± 13)minutes in the study group and control group,with statistically significant difference between groups (t =-2.94,P＜0.05).There was no femoral vascular injury in the 2 groups.The time of drainage-tube removal and duration of postoperative hospital stay were respectively (4.5 ± 1.6) days and (9±4) days in the study group and (3.9± 1.3)days and (10±4)days in the control group,with no statistically significant difference between groups (t =1.36,-0.33,P＞0.05).(2) Follow-up and survival situationsall the 48 patients were followed up for one year.No mesh infection was found in the study group.[ncisional infection was detected in 4 and 2 patients of the study group and control group respectively,with no statistically significant difference between groups (x2 =0.11,P＞ 0.05).Patients with incisional infection were cured after incision open drainage.Two and 2 patients had postoperative chronic pain in the study group and control group respectively,with no statistically significant difference between groups (x2 =0o 20,P＞0.05).The 4 patients had mild intermittent pain,without special treatment.There were no seroma occurred in the 2 groups.Hernia recurrence was occurred in 0 aud 5 patients of the study group and control group respectively,with statistically significant difference between groups (x2 =8.52,P＜0.05).There were 2 and 1 patient dead in the study group and control group respectively,with no statistically significant difference between groups (P ＞ 0.05).Conclusions Hernia repair with Polypropylene mesh via inguinal approach in acute femoral hernia is safe and feasible.Compared to suture repair,it can not only shorten operation time and reduce hernia recurrence,but also had no mesh infection and cannot iucrease postoperative complications.