Risk factors and emergency treatment of preperitoneal space hemorrhage after inguinal hernia repair

Abstract

Objective To investigate risk factors and emergency treatment of inguinal hernia patients with preperitoneal space hemorrhage after preperitoneal repair surgery. Methods A total of 2 096 patients with inguinal hernia in Department of Hernia and Abdominal Wall Surgery of Hangzhou First People's Hospital from January 2012 to December 2016 were treated with preperitoneal repair surgery and used abdominal CT to diagnose their preperitoneal space hemorrhage. Thirty-eight patients with preperitoneal space hemorrhage were included in the case group, and 76 patients without preperitoneal space hemorrhage were included in the control group. The general data of two groups were compared, and the risk factors for preperitoneal space hemorrhage after preperitoneal repair of inguinal hernia were analyzed by Logistic multivariate regression analysis. Results Thirty-seven cases in the case group were cured by non-surgical treatment, and the success rate was 97.37% (37/38). The length of stay [(9.1 + 3.3) d vs. (5.8 + 2.5) d, t = 3.282, P = 0.037], preoperative anticoagulation (26/38 vs. 25/76, χ2 = 4.271, P = 0.002), recurrent hernia (22/38 vs. 25/76, χ2 = 3.450, P = 0.019), prolonged operation time (24/38 vs. 17/76, χ2 = 4.62 8, P = 0.004), the early learning curve (30/38 vs. 15/76, χ2 = 0.655, P = 0.013), decreased hemoglobin [(36 + 13) g/L vs. (22 + 7) g/L, t = 24.21, P < 0.001] and declined blood pressure [(34 + 9) mmHg vs. (17 + 8) mmHg, t = 0.219, P = 0.006] of these two groups were statistically different. These statistically different indicators were included in the Logistic multivariate regression analysis. The results showed that preoperative anticoagulation [OR = 4.759, 95%CI (1.286, 17.606), P = 0.019], recurrent hernia [OR = 2.203, 95%CI (1.051, 6.818), P = 0.025], prolonged operation time [OR = 3.219, 95%CI (1.060, 4.792), P = 0.021], the early learning curve [OR = 13.814, 95%CI (3.731, 51.146), P < 0.001], decreased hemoglobin [OR = 26.255, 95%CI (4.688, 56.343), P = 0.020] and declined blood pressure [OR = 34.091, 95%CI (11.494, 82.442), P < 0.001] were the risk factors of preperitoneal space hemorrhage after preperitoneal repair of inguinal hernia. Conclusions Non-surgical treatment is safe and effective in preperitoneal space hemorrhage after inguinal hernia repair surgery. Preoperative anticoagulation, recurrent hernia, prolonged operation time, the early learning curve, decreased hemoglobin and declined blood pressure were the risk factors of preperitoneal space hemorrhage after inguinal hernia repair surgery. Key words: Hernia, inguinal; Preperitoneal space; Hemorrhage; Risk factors