Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias: a 10-year study.

PURPOSE: The aim of this prospective study was to present a 10-year experience with the use of prosthetic mesh repair in the management of the acutely incarcerated and/or strangulated groin hernias.

METHODS: Patients with acutely incarcerated and/or strangulated groin hernias were treated by emergency repair of the hernia using a Prolene mesh. The presence of non-viable intestine necessitating resection-anastomosis of the bowel was not considered a contraindication to the use of mesh.

RESULTS: The present study included 234 patients. Their age ranged from 16 to 85 years with a mean of 55.9 ± 17.7 years. The hernia was indirect inguinal in 201 patients (85.9%), direct inguinal in 5 patients 5 (2.1%), hernia of canal of nuck in 13 patients (5.6%) and femoral in 15 patients (6.4%). Thirty patients (12.8%) had recurrent hernias. Resection-anastomosis of non-viable small intestine was performed in 32 patients (13.7%). There were 5 perioperative mortalities (2.1%). Complications were encountered in 41 patients (17.5%) and included wound infection in 14 patients (6%), scrotal hematoma in 9 patients (3.8%), chest infection in 8 patients (3.4%), deep vein thrombosis in 2 patients (0.9%), transient deterioration of liver function in 11 patients (4.7%) and mesh infection in 1 patient (0.5%). Follow-up duration ranged from 6 to 120 months with a mean of 62.5 ± 35.3 months. Two recurrences (0.9%) were encountered throughout the study period.

CONCLUSIONS: The use of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated groin hernias is safe. The presence of non-viable intestine cannot be regarded as a contraindication for prosthetic repair.