Choosing best femoral, inguinal hernia surgery method lowers risk of postoperative complications

Selecting the most appropriate surgical method helps suppress the risk of surgical site (SSIs) and mesh infections in the treatment of inguinal and femoral hernias, a recent study has found.

Researchers retrospectively reviewed the medical histories of 1,098 adult patients (mean age 74 years, 88 percent men) who had undergone herniorrhaphy for inguinal and femoral hernias between July 2010 and March 2019. Factors affecting the incidence of SSI and postoperative recurrence, both used as indicators of outcomes, were examined.

Multivariate logistic regression analysis found that blood loss (per 1-mL increase: odds ratio [OR], 1.012, 95 percent confidence interval [CI], 1.004–1.020; p=0.003) and emergency surgery (OR, 8.827, 95 percent CI, 2.969–26.244; p=0.000) significantly increased the risk of postoperative SSI. Meanwhile, no independent predictors were found for postoperative recurrence.

Additionally, postoperative SSI occurred significantly more frequently among patients with long procedure durations, experienced excessive blood loss, needed emergency surgery and bowel resection, and had no mesh sheet insertion. Fifty-four participants underwent recurrent surgeries, which researchers attributed to technical issues during surgery or failure to ligate the hernia sac.

“Our analysis of the occurrence of complications in the treatment of inguinal and femoral hernia revealed that selecting the appropriate surgical method for hernia repair may reduce SSI and mesh infections. However, a laparoscopic approach should be used appropriately, depending on the case,” the researchers said.

“Our study also showed that postoperative recurrence may be further reduced by eliminating hernia sac oversight, and improving surgical techniques,” they added.