Abstract
Background/AimLumbar hernia is caused by a defect in the abdominal wall. Due to its rarity, there is no established consensus on optimal treatment for lumbar hernia yet. Thus, we here investigated the clinical, surgical characteristics and outcomes of lumbar hernia by collecting 28 such patients from our hospital.MethodsPatients diagnosed with lumbar hernia from our institution between April 2011 and August 2020 were retrospectively collected in this study. Demographics, clinical characteristics and surgical information were recorded.ResultsA consecutive series of 28 patients with lumbar hernia were retrospectively collected, including 13 males (46%) and 15 females (54%). The ages of the patients ranged from 5 to 79 years (median: 55 years), with a mean age of 55.6 ± 14.9 years. A total of 7 cases had a history of previous lumbar trauma or surgery. There were 11 (39%), 15 (54%) and 2 (7.1%) cases had right, left and bilateral lumbar hernia, respectively. Superior and inferior lumbar hernia were found in 25 (89%) and 3 (11%) patients. General anesthesia was adopted in 16 cases (group A), whereas 12 patients received local anesthesia (group B). Patients in the group B had a shorter hospital stay than that of the group A (3.5 ± 1.3 days vs. 7.1 ± 3.2 days, p = 0.001), as well as total hospitalization expenses between the two groups (2989 ± 1269 dollars vs. 1299 ± 229 dollars, p < 0.001). With a median follow-up duration of 45.9 months (range: 1–113 months), only 1 (3%) lumbar hernias recurred for the entire cohort.ConclusionsLumbar hernia is a relatively rare entity, and inferior lumbar hernia is rarer. It is feasible to repair lumbar hernia under local anesthesia.
Highlights
The lumbar hernia, is defined as the protrusion of an organ or extraperitoneal contents through a defect in the posterolateral abdominal wall [1], which was first proposed in 1672 by Barbette and the first true case was published by deGarangeor in 1731 [2, 3]
The lumbar region is surgically defined as space between the twelfth rib superiorly, the iliac crest inferiorly, the erector spinae medially, and the external oblique laterally; anatomically, lumbar hernias can be categorised as superior (Grynfeltt-Lesshaft triangle) and inferior (Petit triangle) lumbar hernia [4]
Superior and inferior lumbar hernia were found in 25 (89.3%) and 3 (10.7%) patients; the four hernia sacs of 2 patients who diagnosed with bilateral lumbar hernia were all protruded through the superior lumbar triangles
Summary
The lumbar hernia, is defined as the protrusion of an organ (either intraperitoneal or extraperitoneal) or extraperitoneal contents through a defect in the posterolateral abdominal wall [1], which was first proposed in 1672 by Barbette and the first true case was published by deGarangeor in 1731 [2, 3]. Because the clinical manifestations are often vague or asymptomatic, the diagnosis of lumbar hernia is difficult and is usually not suspected initially. Surgical treatment of lumbar hernias is essential because of risks of incarceration, strangulation and perforation [7,8,9]. Surgical repair can be often difficult considering the location of the hernia and the surrounding bony structures [1, 10]
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