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[Strangulated inguinal hernia]
1Departamento de Cirugía General. Hospital General Gaudencio González Garza. Centro Médico Nacional La Raza. Instituto Mexicano del Seguro Social. México D.F., Mexico. herniagongora@gmail.com
Background:
Strangulated inguinal hernia (SIH) has an overall prevalence of 1.3% in adults, affecting mainly senilepatients, with a high incidence of morbidity and mortality. There are more than 13 different surgical techniques for treatment,but none has proven to be more effective than the others.
Methods:
The present observational, longitudinal and prospective study carried out at Hospital General, Centro MedicoLa Raza in Mexico City proposes a new surgical technique to treat SIH. Between December 2000 and August 2010,43 adult patients with SIH were consecutively subjected to preperitoneal mesh repair and exploratory laparotomy (PPMRand ELAP), a personal modification by the author to the Stoppa-Rives technique. Several variables were studied.
Results:
There was zero mortality. There were no cases of inguinal recurrence or reintervention. One patient developeda granuloma at the surgical site. There were three cases of superficial wound infection, six cases of inguinoscrotal seroma,and one case of incisional hernia.
Discussion:
There is no international consensus on the treatment of SIH although it is interesting to analyze the studiespublished during the last two decades and to observe the results. Studies that propose a preperitoneal approach withmesh demonstrate the best results by reducing morbidity and mortality.
Conclusions:
Preperitoneal mesh repair and exploratory laparotomy reduce the rate of morbidity and mortality in thetreatment of SIH. Inguinal hernias must be repaired at the time of diagnosis to avoid strangulation.
