The outcomes of elective versus emergency inguinal hernia repair in cirrhotic patients

Abstract

Background Cirrhotic patients with ascites and Child classification B or C impose certain limitations on decision making as regards the elective repair of their inguinal hernias. The aim of this study was to evaluate and compare the outcomes of inguinal hernia repair in cirrhotic patients undergoing elective intervention and in those undergoing emergency interventions. Methods Fifty-six cirrhotic patients (Child B or C) undergoing inguinal hernia repair were evaluated. They were classified into two groups based on the type of intervention, elective and emergency surgical intervention (28 patients in each group). Patients were followed up for 12 months after surgery. Operative and postoperative outcomes and quality of life of these patients were recorded and analyzed. Results A total of eight (28.5%) patients died within 30 days after emergency hernia repair. One mortality was recorded in the first 30 days postoperatively in the elective group. Moreover, patients who underwent emergency patients presented with a significantly higher number of perioperative class III-V complications according to the Clavien-Dindo classification (60% in the emergency group vs. 7% in the elective group). Conclusion Elective inguinal hernia repair for cirrhotic patients with ascites is a relatively safe procedure. The improvement in quality of life represents a clear indication for elective hernia repair.