scholarly journals O25 MORTALITY AFTER EMERGENCY VERSUS ELECTIVE GROIN HERNIA REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Ann Hou Saeter ◽  
Siv Fonnes ◽  
Jacob Rosenberg ◽  
Kristoffer Andresen
Keyword(s):  
Systematic Review ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Bowel Resection ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Groin Hernia Repair ◽  
Emergency Repair ◽  
Elective Repair ◽  
Meta Analyses

Abstract Aim This systematic review and meta-analysis aimed to investigate 30- and 90-day postoperative mortality in patients undergoing emergency or elective groin hernia repair. Material and Methods This review is reported after the PRISMA 2020 guidelines. A protocol (CRD42021244412) was registered to PROSPERO. Three databases (PubMed, EMBASE, and Cochrane CENTRAL) were searched in April 2021. The identified studies were screened for eligibility and included if they reported 30- and/or 90-day mortality following emergency or elective groin hernia repair. Meta-analyses were conducted when possible, and a subgroup analysis on patients undergoing bowel resection was made. Results We included 37 studies with a total of 30,740 patients receiving emergency repair and 457,253 receiving elective repair. Meta-analyses could not be conducted for the two repair settings separately due to heterogeneity. However, the 30-day mortality ranged from 0.0–1.7% following elective repair and 0.0–11.8% following emergency repair. The risk of 30-day mortality following emergency repair was estimated to be 26-fold higher than after elective repair. A subgroup meta-analysis on bowel resection in emergency repair estimated 30-day mortality to be 7.9%. Conclusions Emergency groin hernia remains a challenging and potentially fatal surgical emergency. This review emphasizes the importance of performing hernia repair in an elective setting to prevent a potential acute presentation with acute surgical intervention. Patients presenting with symptoms of emergency groin hernias should receive particular attention to minimize the high risk of mortality and morbidity following emergency repair.

scholarly journals Meta-analysis of laparoscopic groin hernia repair with or without mesh fixation

2019 ◽  
Vol 71 ◽  
pp. 190-199 ◽  
Author(s):  
Mokhtar Eltair ◽  
Shahin Hajibandeh ◽  
Shahab Hajibandeh ◽  
Sankar Balakrishnan ◽  
Ahmad Alyamani ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Groin Hernia ◽  
Meta Analysis ◽  
Mesh Fixation ◽  
Groin Hernia Repair ◽  
Laparoscopic Groin Hernia Repair

scholarly journals Trends in Emergent Groin Hernia Repair—An Analysis From the Herniamed Registry

2021 ◽  
Vol 8 ◽  
Author(s):  
Ferdinand Köckerling ◽  
Till Heine ◽  
Daniela Adolf ◽  
Konstaninos Zarras ◽  
Dirk Weyhe ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Bowel Resection ◽  
Emergency Admission ◽  
Female Gender ◽  
Developed Countries ◽  
Perioperative Outcomes ◽  
Groin Hernia Repair ◽  
Gender And Age

Introduction: While the proportion of emergency groin hernia repairs in developed countries is 2.5–7.7%, the percentage in developing countries can be as high as 76.9%. The mortality rate for emergency groin hernia repair in developed countries is 1.7–7.0% and can rise to 6–25% if bowel resection is needed. In this present analysis of data from the Herniamed Registry, patients with emergency admission and operation within 24 h are analyzed.Methods: Between 2010 and 2019 a total of 13,028 patients with emergency admission and groin hernia repairs within 24 h were enrolled in the Herniamed Registry. The outcome results were assigned to the year of repair and summarized as curves. The total patient collective is broken down into the subgroups with pre-operative manual reduction (taxis) of the hernia content, operative reduction of the hernia content without bowel resection and with bowel resection. The explorative Fisher's exact test was used for statistical assessment of significant differences with Bonferroni adjustment for multiple testing.Results: The proportion of emergency admissions with groin hernia repair within 24 h was 2.7%. The percentage of women across the years was consistently 33%. The part of femoral hernias was 16%. The proportion of patients with pre-operative reduction (taxis) remained unchanged at around 21% and the share needing bowel resection was around 10%. The proportion of TAPP repairs rose from 21.9% in 2013 to 38.0% in 2019 (p < 0.001). Between the three groups with pre-operative taxis, without bowel resection and with bowel resection, highly significant differences were identified between the patients with regard to the rates of post-operative complications (4% vs. 6.5% vs. 22.7%; p < 0.0001), complication-related reoperations (1.9% vs. 3.8% vs. 17.7%; p < 0.0001), and mortality rate (0.3% vs. 0.9% vs. 7.5%; p < 0.001). In addition to emergency groin hernia repair subgroups female gender and age ≥66 years are unfavorable influencing factors for perioperative outcomes.Conclusion: For patients with emergency groin hernia repair the need for surgical reduction or bowel resection, female gender and age ≥66 years have a highly significantly unfavorable influence on the perioperative outcomes.

Systematic review of neuropathic component in persistent post-surgical pain

2012 ◽  
Vol 3 (3) ◽  
pp. 184-184
Author(s):  
S. Haroutiunian ◽  
L. Nikolajsen ◽  
N.B. Finnerup ◽  
T.S. Jensen
Keyword(s):  
Systematic Review ◽  
Neuropathic Pain ◽  
Hernia Repair ◽  
Varicose Vein ◽  
Groin Hernia ◽  
Iliac Crest ◽  
Gynecologic Surgery ◽  
Groin Hernia Repair ◽  
Pain Mechanisms ◽  
Surgical Pain

Abstract Background/aim The aim of the current study was to assess the neuropathic component of persistent post-surgical pain (PPSP) following eleven types of surgery. Methods We performed a systematic PubMed, CENTRAL and EMBASE search to identify studies on PPSP following (i) thoracic surgery, (ii) breast surgery, (iii) groin hernia repair, (iv) prostatectomy, (v) major abdominal surgery, (vi) gynecologic surgery, (vii) iliac crest bone harvest, (viii) total hip arthroplasty (THA) or knee arthroplasty (TKA), (ix) varicose vein stripping or ablation, (x) mandibular sagittal split osteotomy and (xi) donor nephrectomy, and assessed the prevalence of Probable/Definite neuropathic pain using the recently published neuropathic pain probability grading criteria [1]. Results We included 291 relevant papers. Surgeries performed in the thoracic/breast area resulted in similarly high median PPSP prevalence of about 30–35%; bone and joint surgeries resulted in similar PPSP prevalence of about 20%; and surgeries on visceral organs resulted in lower PPSP prevalence of 10–14%. The reported ranges of PPSP prevalence were very wide, between 0 and 91%. The prevalence of Probable/Definite neuropathic pain among patients with PPSP was about 65% after thoracic and breast surgeries, about 32% after groin hernia repair and gynecologic surgery, and between 9 and 16% after bone and joint surgeries such as iliac crest bone harvest and THA/TKA. In varicose vein surgeries and mandibular sagittal split osteotomies more research is needed to investigate the contribution of neuropathic pain mechanisms. Conclusion PPSP after different surgeries is reported to be common and often neuropathic. This systematic review of the literature showed that reported PPSP prevalences range widely among studies, and only a minority of studies used methodology that enabled the estimation of Probable/Definite neuropathic pain prevalence.

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