Comparative study between anterior and posterior approach in emergent femoral hernia

Abstract

Objectives/aims Emergency surgery is necessary for incarcerated and/or strangulated femoral hernias. With regard to emergency femoral hernia repair, this study attempted to compare between open anterior and open posterior (preperitoneal) techniques. Methods Patients who underwent emergency femoral hernia repair between October 2020 and October 2022 were included in this single centre retrospective cohort research. They were divided into two groups based on the surgical incisions: the anterior approach group (19 cases) and the posterior approach group (14 cases). Open anterior and posterior methods were compared using patient demographic information, intraoperative findings, operating time, and postoperative outcomes. Results 33 patients in total were included in the current study. 19 patients (57.6%) underwent open anterior approach, whereas 14 patients (42.4%) underwent open preperitoneal approach. Patient features indicated a similarity between the two groups. The posterior approach group experienced considerably shorter mean operative time (53.624 7 min vs 77.936 5 min, P = 0.039) and recovery time (9.24 1days vs 13.36 6days, P = 0.049) before returning to full activity. The posterior approach group had a decreased (7.14%) rate of postoperative complications, such as wound infection, seroma/hematomas, persistent discomfort, and hernia recurrence. Conclusion While it can increase the rate of first-stage tension-free repair of incarcerated femoral hernia and with a lower risk of postoperative complications, the open preperitoneal approach for emergency femoral hernia may be preferable to other procedures.