Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

Lozada-Martínez, Iván David; Covaleda-Vargas, Jaime Enrique; Gallo-Tafur, Yuri Alexandra; Mejía-Osorio, David Andrés; González-Pinilla, Andrés Mauricio; Florez-Fajardo, Mayra Alejandra; Benavides-Trucco, Fabian Enrique; Santodomingo-Rojas, Julio Cesar; Bueno-Prato, Nancy K.J.; Narvaez‐Rojas, Alexis Rafael

doi:10.1016/j.amsu.2022.103953

Cited by 4 publications

(3 citation statements)

References 52 publications

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“…Hernia is a common pathology that is believed to arise from biomechanical and biochemical alterations within a specific muscle or a group of muscles. More than 20 million surgeries are performed annually around the globe to correct hernias 1 . While these surgeries might be considered routine procedures, the cumulated recurrence risk can range from 15 to 35% after hernia repair 2 , according to a large scale study of ventral hernias that covered 2.5 million people over a period of 4 years.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical stability of hernia-damaged abdominal walls

Karrech

Ahmad

Hamdorf

2023

Sci Rep

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Hernia occurs when the peritoneum and/or internal organs penetrate through a defect in the abdominal wall. Implanting mesh fabrics is a common way to reinforce the repair of hernia-damaged tissues, despite the risks of infection and failure associated with them. However, there is neither consensus on the optimum mesh placement within the abdominal muscles complex nor on the minimum size of hernia defect that requires surgical correction. Here we show that the optimum position of the mesh depends on the hernia location; placing the mesh on the transversus abdominis muscles reduces the equivalent stresses in the damaged zone and represents the optimum reinforcement solution for incisional hernia. However, retrorectus reinforcement of the linea alba is more effective than preperitoneal, anterectus, and onlay implantations in the case of paraumbilical hernia. Using the principles of fracture mechanics, we found that the critical size of a hernia damage zone becomes severe at 4.1 cm in the rectus abdominis and at larger sizes (5.2–8.2 cm) in other anterior abdominal muscles. Furthermore, we found that the hernia defect size must reach 7.8 mm in the rectus abdominis before it influences the failure stress. In other anterior abdominal muscles, hernia starts to influence the failure stress at sizes ranging from 1.5 to 3.4 mm. Our results provide objective criteria to decide when a hernia damage zone becomes severe and requires repair. They demonstrate where mesh should be implanted for a mechanically stable reinforcement, depending on the type of hernia. We anticipate our contribution to be a starting point for sophisticated models of damage and fracture biomechanics. For example, the apparent fracture toughness is an important physical property that should be determined for patients living with different obesity levels. Furthermore, relevant mechanical properties of abdominal muscles at various ages and health conditions would be significant to generate patient specific results.

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Section: Introductionmentioning

confidence: 99%

Biomechanical stability of hernia-damaged abdominal walls

Karrech

Ahmad

Hamdorf

2023

Sci Rep

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“…However, studies so far have reported less postoperative pain and shorter recovery time at one year in patients who are taken to preperitoneal approach, so this topic is proposed as a point that requires future research [1,5]. In Latin America, where low-and middle-income countries predominate, which have limited resources, technology and barriers to timely access to health services, open surgery techniques are frequently used in some regions, being imperative the constant evaluation of outcomes [6,7], to know the behavior and factors that in uence the performance of one technique compared to another. Therefore, the aim of this study was to compare the postoperative outcomes of Lichtenstein-type open hernioplasty versus Nyhus-type preperitoneal hernioplasty, with a one-year follow-up in a referral center in Colombia.…”

Section: Introductionmentioning

confidence: 99%

Perioperative outcomes using Lichtenstein-type open hernioplasty versus Nyhus-type preperitoneal hernioplasty in inguinal hernia: a comparative study with 1-year follow-up

Cabrera‐Vargas

Mendoza‐Zuchini

Aparicio

et al. 2022

Preprint

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Background Inguinal hernia are the most common defect of the abdominal wall in 75% and their treatment consists of surgical repair. The technique of choice is laparoscopic because of its overall benefits. However, when this is not available, open approaches may be a viable option. Currently the most commonly used open techniques are Lichtenstein and Nyhus. However, there are no long-term studies that have compared outcomes between these two techniques. Methods Retrospective comparative study that included patients undergoing open inguinal hernia correction with mesh, using Lichtenstein-type open hernioplasty versus Nyhus-type preperitoneal hernioplasty, in two centers in Bogota, Colombia, during a period of two years. Frequencies and percentages were calculated. A bivariate analysis was performed to compare groups, according to the complications presented between the two techniques. Results 193 patients were included, of whom 53.36% were men and 58.03% (n = 112) were approached with the Nyhus technique. Non-absorbable suture fixation was performed in 100% of patients. Among the main complications, seroma (5.18%), pain (4.14%), bleeding (2.07%), recurrence (10.88%) and reoperation (0.51%) were observed, of which only recurrence showed a statistically significant difference, being lower in the Nyhus approach (3.57% vs. 20.67%; p < 0.001). No patients died. Conclusions Both Nyhus- and Lichtenstein-type hernioplasty techniques were shown to cause a low incidence of postoperative complications with zero mortality, with significantly lower recurrence using the Nyhus technique up to 1 year postoperatively.

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“…1 However, studies so far have reported less postoperative pain and shorter recovery time at 1 year in patients who underwent the preperitoneal approach, so this topic is proposed as a point that requires future research. 1,5 In Latin America, where low-and middle-income countries predominate, which have limited resources, technology, and barriers to timely access to health services, open surgery techniques are frequently used in some regions, which is imperative for the constant evaluation of outcomes, 6,7 to know the behavior and factors that influence the performance of one technique compared to another. Therefore, the aim of this study was to compare the postoperative outcomes of Lichtenstein open hernioplasty versus Nyhus preperitoneal hernioplasty, with a 1-year follow-up in two tertiary referral centers in Colombia.…”

mentioning

confidence: 99%

Postoperative outcomes using Lichtenstein open hernioplasty versus Nyhus preperitoneal hernioplasty in inguinal hernia: A comparative analysis with 1‐year follow‐up

Vargas

Mendoza‐Zuchini

Pedraza

et al. 2023

Health Science Reports

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Background and Aim: Inguinal hernia is the most common defect of the abdominal wall in 75% and their treatment consists of surgical repair. The technique of choice is laparoscopic because of its overall benefits. However, when this is not available, open approaches may be a viable option. Currently, the most commonly used open techniques are Lichtenstein and Nyhus. However, there are few medium-or longterm studies that have compared outcomes between these two techniques.Methods: This is a retrospective comparative study that included patients undergoing open inguinal hernia correction with mesh, using Lichtenstein open hernioplasty versus Nyhus preperitoneal hernioplasty, in two tertiary referral centers in Bogota, Colombia, during a period of 2 years. A bivariate analysis was performed to compare groups, according to the complications presented between the two techniques.Results: A total of 193 patients were included, of whom 53.36% were men and 112 (58.03%) were approached with the Nyhus technique versus 81 patients with the Lichtenstein technique. Nonabsorbable suture fixation was performed in 100% of patients. Among the main complications, seroma (5.18%), pain (4.14%), bleeding (2.07%), recurrence (10.88%), and reoperation (0.51%) were observed, of which only recurrence showed a statistically significant difference, which is lower in the Nyhus approach (3.57% vs. 20.67%; p < 0.001). No patients died.Conclusions: Both Nyhus and Lichtenstein hernioplasty techniques were shown to cause a low incidence of postoperative complications, with significantly lower recurrence using the Nyhus technique up to 1 year postoperatively.

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Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

Cited by 4 publications

References 52 publications

Biomechanical stability of hernia-damaged abdominal walls

Biomechanical stability of hernia-damaged abdominal walls

Perioperative outcomes using Lichtenstein-type open hernioplasty versus Nyhus-type preperitoneal hernioplasty in inguinal hernia: a comparative study with 1-year follow-up

Postoperative outcomes using Lichtenstein open hernioplasty versus Nyhus preperitoneal hernioplasty in inguinal hernia: A comparative analysis with 1‐year follow‐up

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