Outcome of emergency groin hernia repair in a district general hospital.

Abstract

Abstract Background Tension free mesh repair is considered as gold standard technique for elective groin hernia repair. However, use of synthetic mesh remains controversial in the presence of gangrenous bowel, contaminated or infected surgical field. Aims/ Objective This study aimed to evaluate the outcome of emergency groin hernia repair, to assess the safety of mesh repair and explore risk factors of postoperative complications for adult patients with incarcerated groin hernia. Methods From April 2019 to August 2022, consecutive adult patients who underwent emergency repair for incarcerated groin hernia in our trust were retrospectively reviewed. Data was collected from electronic patient record, which includes patient demographics, type of hernia, repair (mesh/ non mesh), and the outcome in terms of early and late postoperative complications. Results 153 patients underwent emergency groin hernia repair, of these 137 were primary and 15 recurrent. Median age was 75.5 (range 23 to 96), with male to female ratio 3:1. 80 percent cases were inguinal hernia and 20 percent femoral. 75 percent patients had mesh repair and remaining had suture repair done. Bowel resection was performed in 11 cases. Early complications were reported in 7 cases (hematoma 2, seroma 2, chronic pain 2 , recurrence 1 and infection 1) and late complications within 90 days were seen in 5 cases (recurrence, groin pain, adhesions). Conclusions Polypropylene mesh could be safely used in incarcerated groin hernia repair. However, suture repair is recommended when bowel resection is required. Delay in surgical repair, obesity and co-morbidities are risk factor of post-operative complications.