Tension-free mesh repair for incarcerated groin hernia

Objective To investigate the safety and efficacy of tension-free mesh repair in the treatment of incarcerated groin hernia, and to compare the outcome of biological mesh and polypropylene mesh repairment. Methods A retrospective study was conducted on 118 patients admitted from Jan 2013 to Dec 2017 receiving emergency incarcerated groin hernia repair in Beijing Chao-Yang Hospital. The incidence of surgical site infection (SSI), perioperative mortality, sepsis and ileus were compared. In the follow-up, the postoperative foreign body sensation, chronic pain, seroma/hematoma and recurrence were recorded. The outcome of different surgical procedures (with mesh/without mesh, biological mesh/polypropylene mesh, TAPP/Lichtenstein repair) were compared and analyzed. Results 14 cases received suture repair (group A), 104 cases underwent TAPP (n=44) repair or Lichtenstein repair (n=60) with meshes, including 23 cases using biological mesh (group B) and 81 cases using polypropylene mesh (group C). After 20.5 months of follow-up (ranging from 6-65 months), 3 cases in group A (21.4%) developed recurrence, the rate was significantly higher than that of group B (4.3%) and group C (0). The incidence of seroma /hematoma in group B was higher than that in group A (7.1%) and group C (7.4%). There were no significant differences between the 3 groups regarding the postoperative adverse events rate, SSI, mortality, sepsis and ileus(all P>0.05). Conclusions Tension-free mesh repair in the treatment of emergency incarcerated groin hernia is safe and effective, which can reduce the recurrence rate of hernia, without increasing the risk of infection. Key words: Hernia, inguinal; Heniorrhaphy; Biological mesh