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Hepatic cirrhosis and groin hernia: binomial or dichotomy? Our experience with a safe surgical treatment protocol
Adelmo Gubitosi1, Roberto Ruggiero, Giovanni Docimo
1Department of Emergency, Second University of Naples, Naples, Italy. adelmo.gubitosi@unina2.it
Insights
This study shows that specific pre- and post-operative measures can improve outcomes for cirrhotic patients undergoing inguinal hernia repair. These surgical enhancements enhance safety and effectiveness in managing hernias in patients with liver cirrhosis.
Area of Science:
- Hepatology
- Surgical Gastroenterology
- Clinical Surgery
Background:
- Hepatitis B and C are common in Campania, Italy, leading to a high prevalence of liver cirrhosis.
- Cirrhosis significantly complicates surgical outcomes, particularly for abdominal wall hernias like inguinal hernias.
- Inguinal hernia repair in cirrhotic patients historically carries a poor prognosis.
Purpose of the Study:
- To evaluate the safety and effectiveness of specific parasurgical measures in cirrhotic patients undergoing inguinal hernioplasty.
- To assess the impact of a standardized surgical protocol on hernia repair outcomes in this high-risk population.
Main Methods:
- A study was conducted on 52 patients with liver cirrhosis who underwent inguinal hernioplasty.
- The surgical protocol included: short-term antibiotic prophylaxis, perioperative concentrated platelet infusion, non-opening of the hernia sac, human fibrin glue application, and elastic compression.
- Data was analyzed using EPI INFO 3.5 statistical software.
Main Results:
- The study evaluated the effectiveness and safety of the described parasurgical measures in cirrhotic patients.
- The specific protocol aimed to mitigate the negative outcomes typically associated with inguinal hernia repair in this patient group.
Conclusions:
- The implemented parasurgical measures and surgical protocol were assessed for their impact on outcomes in cirrhotic patients undergoing inguinal hernioplasty.
- This study provides insights into optimizing surgical management for inguinal hernias in patients with liver cirrhosis.
Abstract:
Hepatitis B and C are endemic in the Campania region of Italy, and as a result there are many patients with hepatitis-related cirrhosis. The medical community is therefore faced with a series of issues which must be dealt with and which are especially relevant to various areas of surgery. Abdominal wall hernias occur very frequently in cirrhotic patients, and hepatic cirrhosis has always been the harbinger of a negative outcome in patients undergoing inguinal hernia repair. The aim of this study, conducted on 52 cirrhotic patients who underwent inguinal hernioplasty, was to evaluate the effectiveness and safety of surgical treatment when certain parasurgical measures are used. These measures and the notes we inserted in our surgical protocol include the following: short-term antibiotic prophylaxis, perioperative infusion of concentrated platelets, not opening the hernia sac, application of human fibrin glue, elastic compression. All patients were treated according to the same protocol and the data was analysed using the statistics software EPI INFO 3.5.