title: Inguinal hernia repair in patients with cirrhosis is not associated with increased risk of complications and recurrence.
abstract: BACKGROUND
  Although inguinal hernia in patients with liver cirrhosis (LC) is not uncommon, literature comparing operative complications and long-term recurrence rate after inguinal hernia repair in LC patients and non-LC patients is limited.
  
  
  METHODS
  A total of 780 eligible patients including 129 (16.5%) patients with LC underwent inguinal hernia repair with the standard McVay procedure by a single surgeon over a 10-year period. Patients were prospectively registered and clinical data were analyzed retrospectively.
  
  
  RESULTS
  In the LC group, 45 patients were of Child-Turcotte-Pugh (CTP) class A (34.9%), 66 were class B (51.1%), and 18 were class C (14.0%). Eighty-one patients with LC (62.8%) had ascites at the time of operation. Postoperative complications occurred in 14 LC patients (10.9%). Complication rate was unrelated to CTP class (A:B:C=11.1%:9.1%:16.7%; P=0.69) and was not higher than among non-LC patients (6.8%; P=0.11). Two LC patients (1.6%) of CTP class C died postoperatively from hepatic failure. In LC group patients, median follow-up was 22.9 months and recurrence developed in three (2.3%). Cumulative recurrence rates were not significantly different between the LC and non-LC patient groups (P=0.87). The cumulative rate of contralateral side hernia development was also similar between the two groups (P=0.63).
  
  
  CONCLUSIONS
  Our results indicate that the incidence of postoperative complications and long-term recurrence after inguinal hernia repair in LC patients does not differ from that in non-LC patients. Elective repair of symptomatic inguinal hernia in patients with cirrhosis should be advocated.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, and Seoul National University Hospital, Healthcare System Gangnam Center, 101 Daehango (28 Yongon-dong), Jongno-Gu, Seoul, 110-744, Korea.
authors.forename: Heung-Kwon
authors.initials: HK
authors.lastname: Oh
authors.forename: Hansuk
authors.initials: H
authors.lastname: Kim
authors.forename: Seungbum
authors.initials: S
authors.lastname: Ryoo
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Choe
authors.forename: Kyu Joo
authors.initials: KJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D012008:Recurrence; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000503:physiopathology; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult