[Elective inguinal hernioplasty in patients on chronic anticoagulation therapy. Management and outcome].
BACKGROUND
Perioperative management of patients on anticoagulant therapy increases the complexity of elective inguinal hernia repair. We assessed the safety of our standardised anticoagulation protocol and investigated the outpatient and one day surgery rates.


METHODS
The records of 1184 patients undergoing elective inguinal hernioplasty between 2005 and 2007 were reviewed; 14 patients on chronic anticoagulation therapy were identified. We used a standard bridging therapy protocol with low-molecular-weight heparins. Outcomes were assessed at 30 days post-procedure and included bleeding, thromboembolic events or death and type of hospital admission.


RESULTS
Mean age was 74+/-10 years; 12 (25%) patients were high risk for thromboembolism and 31 (67%) patients were ASA III. Almost all inguinal repairs were performed using a polypropylene mesh; 6 (13%) patients had a surgical site haematoma and there was 1 (2.7%) major bleeding, that was re-operated on. No thromboembolic events or deaths occurred; 11 (23%) patients were treated on an outpatient basis and 16 (34%) on a one day surgery regimen. Mean hospital stay was 2.4+/-5.1 days.


CONCLUSIONS
Elective inguinal hernioplasty in patients on chronic oral anticoagulation therapy using a standard bridging protocol is a safe procedure. Chronic anticoagulation therapy is not a contraindication for ambulatory surgery.
Bombuy
Ernest
E
Servicio de Cirugía General, Hospital de Mataró, Mataró, Barcelona, España. 30622ebg@comb.es
Mans
Esther
E
Hugué
Alejandro
A
Plensa
Esther
E
Rodriguez
Lluís
L
Prats
Miquel
M
Suñol
Xavier
X
D000368:Aged; D000556:Ambulatory Surgical Procedures; D000925:Anticoagulants / Q000627:therapeutic use*; D000075202:Contraindications; D017558:Elective Surgical Procedures; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome
D000925:Anticoagulants