Management of groin hernias in patients with ascites

• Published in: Annals of surgery Vol. 216; no. 6; pp. 696 - 700
• Main Authors: HURST, R. D, BUTLER, B. N, SOYBEL, D. I, WRIGHT, H. K
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.12.1992
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Ascites - complications; Ascites - therapy; Biological and medical sciences; Female; Hernia, Femoral - complications; Hernia, Femoral - surgery; Hernia, Inguinal - complications; Hernia, Inguinal - surgery; Humans; Liver Cirrhosis - complications; Male; Medical sciences; Middle Aged; Postoperative Complications; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Human; Hepatic disease; Inguinal; Hernia; Cirrhosis; Concomitant disease; Treatment; Follow up study; Abdominal disease; Surgery; Digestive diseases; Adult; Ascites; Elderly
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-199212000-00013

The records of 18 cirrhotic patients with ascites and groin hernias (20 inguinal and one femoral) were retrospectively reviewed. Eleven patients underwent repair of their groin hernias (total of 13 repairs). Ten herniorrhaphies were performed electively, two were performed urgently because of recent difficult reduction, and one was performed emergently for incarceration without strangulation. No major and four minor postoperative complications occurred. There were no perioperative deaths or ascites leaks. Of the 13 hernias in 11 patients undergoing repair, 12 (92%) were available for follow-up. In this group, the 12 groin hernia repairs were followed for a mean of 25 months. One recurrence (8%) occurred 11 months after repair. In this same group of patients, five umbilical hernias were repaired, with three recurrences (60%). From this retrospective study, it appears that serious complications from groin hernias in cirrhotics are not common, and elective repair can usually await control of ascites. Additionally, for appropriately selected patients with ascites, elective inguinal hernia repair can be performed safely, with an acceptable rate of recurrence.