Inguinal hernia recurrence: classification and approach.
We reviewed case reports, updated to January 2005, of 2,468 operations for groin hernia in 2,350 patients, including 277 recurrent hernias. The data obtained, following a simple anatomo-clinical classification into three types that could be used to orient surgical strategy, were: type R1--first recurrence of "high" oblique external reducible hernia with small (<2 cm) defect in non-obese patients after pure tissue or mesh repair; type R2--first recurrence of "low" direct reducible hernia with small (<2 cm) defect in non-obese patients after pure tissue or mesh repair; and type R3--all other recurrences, including femoral recurrences, recurrent groin hernia with large defect (inguinal eventration), multi-recurrent hernias, non-reducible contralateral primary or recurrent hernia, and situations compromised by aggravating factors (e.g. obesity) or otherwise not easily included in R1 or R2 after pure tissue or mesh repair.
Campanelli
G
G
Department of Surgical Sciences, Policlinico Hospital I.R.C.C.S., University of Milano, Milano, Italy. giampiero.campanelli@unimi.it
Pettinari
D
D
Nicolosi
F M
FM
Cavalli
M
M
Avesani
E Contessini
EC
D005260:Female; D006552:Hernia, Inguinal / Q000145:classification* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence