OC-002 EVALUATION OF GIANT INGUINAL HERNIA REPAIR RESULTS - A RETROSPECTIVE SINGLE INSTITUTION CASE-CONTROL PROPENSITY SCORE MATCHED STUDY

Abstract

Abstract Background Giant inguinal hernia (GIH), defined as a hernia descending below the inner-thigh midpoint in upright position, is rare. Case reports describe techniques in which the abdominal cavity is prepared and care is taken to prevent abdominal compartment syndrome (ACS). Our aim was to analyze and review our experience with GIH repair. Methods Retrospective single-institution, case-control, study included adults who underwent GIH repair between 2014–2021 at an university referral center. Technique included endo-tracheal intubation, head-down positioning, maximal pre-incision reduction of hernia contents, and repair with mesh. Follow-up was conducted in outpatient clinic. Results were compared to a time-based control group. Results During the study period, 58 patients underwent an open GIH repair with mesh without abdominal preparation. Control group included 232 patients who underwent open non-giant inguinal hernia repair (control group). Bowel resection was not necessary in any case. The in-hospital and 30-day complication rates were 17.2% and 68.9% in the GIH group, and 8.2% and 27.2%, in the control group (p=0.04, OR=2.3; and p<0.001, OR=5.9, respectively). Ischemic orchitis was common in the GIH group (65.5%) compared to the control group (13.4%) (p<0.001, OR=12.3). ACS, major complications and mortality were not reported. 90-day complication rates were similar. 2 cases of recurrence (0.9%) were observed in the control group. Conclusions Our study suggests that GIH repair is safe and feasible, and there is no need for abdominal cavity preparation. Early complications, mainly ischemic orchitis, are more common than control group, but without long-term implications and with a very low recurrence rate.