Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias: a 10-year study.
OBJECTIVE
The aim of this prospective study was to present a 10-year experience with the use of prosthetic mesh repair in the management of the acutely incarcerated and/or strangulated groin hernias.


METHODS
Patients with acutely incarcerated and/or strangulated groin hernias were treated by emergency repair of the hernia using a Prolene mesh. The presence of non-viable intestine necessitating resection-anastomosis of the bowel was not considered a contraindication to the use of mesh.


RESULTS
The present study included 234 patients. Their age ranged from 16 to 85 years with a mean of 55.9 ± 17.7 years. The hernia was indirect inguinal in 201 patients (85.9%), direct inguinal in 5 patients 5 (2.1%), hernia of canal of nuck in 13 patients (5.6%) and femoral in 15 patients (6.4%). Thirty patients (12.8%) had recurrent hernias. Resection-anastomosis of non-viable small intestine was performed in 32 patients (13.7%). There were 5 perioperative mortalities (2.1%). Complications were encountered in 41 patients (17.5%) and included wound infection in 14 patients (6%), scrotal hematoma in 9 patients (3.8%), chest infection in 8 patients (3.4%), deep vein thrombosis in 2 patients (0.9%), transient deterioration of liver function in 11 patients (4.7%) and mesh infection in 1 patient (0.5%). Follow-up duration ranged from 6 to 120 months with a mean of 62.5 ± 35.3 months. Two recurrences (0.9%) were encountered throughout the study period.


CONCLUSIONS
The use of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias is safe. The presence of non-viable intestine cannot be regarded as a contraindication for prosthetic repair.
Department of General Surgery, Faculty of Medicine, University of Alexandria, Al-Azarita, Alexandria, Egypt. samerbessa@gmail.com.|General Surgery Department, Faculty of Medicine, University of Alexandria, Midan Al-Khartoum, Mahatet Al-Raml, Alexandria, Egypt. samerbessa@gmail.com.
S S
SS
Bessa
Department of General Surgery, Faculty of Medicine, University of Alexandria, Al-Azarita, Alexandria, Egypt.
M R
MR
Abdel-fattah
Department of General Surgery, Faculty of Medicine, University of Alexandria, Al-Azarita, Alexandria, Egypt.
I A
IA
Al-Sayes
Department of General Surgery, Faculty of Medicine, University of Alexandria, Al-Azarita, Alexandria, Egypt.
I T
IT
Korayem
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D005260:Female; D006119:Groin / Q000601:surgery; D006550:Hernia, Femoral / Q000601:surgery*; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D007511:Ischemia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011446:Prospective Studies; D013526:Surgical Mesh; D055815:Young Adult
D011126:Polypropylenes
Acute incarceration; Groin hernia; Intestinal ischemia; Polypropylene mesh; Prosthetic repair