P163 ROLE OF THE LAPAROSCOPIC APPROACH IN EMERGENT INGUINAL HERNIA REPAIR. (25th November 2021)

• Record Type: Journal Article
• Authors: Frias, Joan Ricard Soler; León, Anabel García; Tallon-Aguilar, Luis; González, Jose Tinoco; Arteaga, Alejandro Sánchez; Ruiz, Francisco Javier Padillo
• Is Part Of: British journal of surgery. Volume 108:Supplement 8(2021)
• Publication Date: 2021-11-25
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab395.152
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aim: Analyze the evolution of the laparoscopic approach in emergent inguinal hernia repair at our center. Material and Methods: Retrospective review of patients with emergent inguinal hernia repair in our center from January 2011 to June 2020. Demographic, clinical and postoperative data were analyzed as well as the evolution of the laparoscopic approach. Results: 385 patients with incarcerated/strangulated inguinal hernia were registered. 58.96% were men, with a median age of 71. Of those, 22 patients (5.71%) were treated by laparoscopic approach and 363 (94.29%) by open approach. The open approach had a longer median hospitalization (4.82 vs 1.66 days), higher rate of surgical wound infection (5.51% vs. 0%), higher reoperation rate (3.31% vs 0%) and higher incidence of respiratory complications (1.97% vs 0%). 1 patient (4.54%) with laparoscopic approach required intestinal resection vs 48 patients (13.22%) of the open group, with a dehiscence rate of 0% vs 4.76% respectively. Mortality rate was 0% for the laparoscopic group and 2.75% in the open group. In the last 18 months, 28.98% of urgent hernias repaired have been performed laparoscopically, while previously from 2011 to 2017 only 0.95%, due to the learning curve obtained in elective surgery where the laparoscopic approach has had a major development in the last 3 years. Conclusions: Despite the evident patient selection bias because the approach choice by the surgeon in emergent inguinal hernia repair, laparoscopic approach is feasible and has lower morbidity-mortality compared to open approach in our center. In specialized centers this may be a treatment option for selected patient groups.