OC-046 SURGICAL ASPECTS AND EARLY MORBIDITY OF RECURRENT INGUINAL HERNIAS DURING OPEN REOPERATION

Abstract

Abstract Background Inguinal hernia recurrences (IHR) are relatively common and have higher complexity and complication risk at reoperation when compared with primary inguinal hernias (PIH). This study aims to further characterize the patterns of recurrence and early complications observed by type of hernia repair at the index surgery. Methods After REB approval, a review of charts from patients undergoing elective first reoperation for IHR from 2013–2017 was performed. First operations were classified as: childhood repair, laparoscopic repair, open tissue repair, open mesh repair and Shouldice repair. Early complication included hematoma, infection and seroma. Statistical analyses were completed. Results A total of 1281 patients underwent 1340 surgeries for IHR in the study period (4.9% of all inguinal hernias operated). There wa an increased proportion of males, direct type hernias and wound infection in IHR group (p<.001) when compared with PIH repairs. During surgical procedure, the length of surgery was longer, scarring of tissues heavier, nerve identification lower in patients with previous open mesh and Shouldice repairs, in comparison to other groups (childhood, laparoscopic and open repair - p<.001). Conclusion Recurrent inguinal hernia repairs present higher complexity than PIH repairs and incurr in higher chances of early postoperative complications. The type of PIH repair technique influences surgical difficulties encountered in the open reoperation, with open mesh and Shouldice techniques being associated with higher surgical difficulty. This information may help in surgical planning, according with the anticipated leverl of procedure difficulty.