Safety and effectiveness of inguinal hernia repair in patients with liver cirrhosis: a retrospective study and literature review

Inguinal Hernias in Cirrhotic Patients: From Diagnosis to Treatment

“…Among several reports commenting on spinal anesthesia, its administration ranged from 3.8% to 58.9% of patients. 18,19,28,29 In a case series published by Pere, spinal anesthesia was the method of choice in all 3 patients. 30 Of note, great attention should be given to platelet counts as coexistent thrombocytopenia constitutes an absolute contraindication for spinal centesis.…”

“…On the other hand, several published reports describe primary repairs of inguinal hernias without mesh in the setting of cirrhosis and ascites. 18,29,40 However, strong evidence describes that repair with mesh augmentation leads to favorable results with low complication rates. 3,8,9,27,41 The application of mesh (most commonly Prolene mesh) relies on preserving the hernia sack intact during the operation to avoid ascites leakage, fluid collections, and potential mesh contamination.…”

“…The rate of drainage placement after hernia repair in patients with cirrhosis as documented in 2 studies ranged from 14% (4/28 patients) to 50% (18/36 patients). 17,18 Administration of antibiotics in cases with mesh was documented in 4 studies; in 3 of them, all patients received antibiotic prophylaxis. 17,28,39 In the remaining report (Li et al 18 ), where 21 repairs were done with mesh, 18 of 29 patients received prophylaxis.…”

“…17,18 Administration of antibiotics in cases with mesh was documented in 4 studies; in 3 of them, all patients received antibiotic prophylaxis. 17,28,39 In the remaining report (Li et al 18 ), where 21 repairs were done with mesh, 18 of 29 patients received prophylaxis. Unfortunately, despite the fact that at least 3 cases with mesh received no prophylaxis, no criteria for decision-making were reported by the authors.…”

“…Most of the existing studies do not specifically comment on cases of recurrent hernias or have excluded such cases from further analysis. Oh et al 29 had 3 cases of recurrent hernias, 3 additional isolated reports described open repairs, 18,19,40 and Wang et al 39 reported 4 cases of recurrent inguinal hernias successfully treated with TEP. Interestingly, 2 of them were intraoperatively found to be combined with femoral and obturator hernias.…”