Groin hernias: features of recurrences |
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Authors: | E P Pélissier D Blum A Elhaimeur P Marre J M Damas |
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Institution: | 1. Clinique Saint Vincent, 40 Chemin des Tilleroyes, F-25000, Besan?on, France 2. Centre de Chirurgie Herniaire, Paris la Défense, 2-14, rue Paul Napoléon Roinard, F-92400, Courbevoie, France
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Abstract: | Summary In 2390 groin hernias operated on by the same surgeon there were 2327 inguinal hernias (97.4%) and 63 femoral (2.6%); 261
(11.2%) were recurrent hernias. The aim of this study was to define the different features of recurrences in a series of 206
recurrences operated on by an inguinal approach. The median time of recurrence was 3 years (< 1–58). It was < 1 year in 67
cases (40%) and 50% of all recurrences had occurred in 2.4 years. The time of recurrence after operation performed in childhood
was 31 years (15–58). All recurrences were located in the area of the myo-pectineal and femoral orifices. There was only one
site of recurrence in 125 cases (61%); the recurrence was direct in 73 cases (58%), indirect in 44 cases (35%) and femoral
in 8 cases (7%). There were 2 sites of recurrence in 81 cases (39%), 76 mixed (94%) and 6 inguinal associated with a femoral
hernia (6%). Altogether there were 288 sites of recurrence. There were 44 direct diverticular recurrences and 26 of these
were located near the pubic tubercle.
The rate of recurrence in current practice is much higher than that in specialized centers. The long delay of recurrence after
simple resection of the sac in childhood constitutes an indirect argument for the Marcy procedure in adolescents and young
men with type I or II hernias. The preeminence of direct recurrences and the existence of direct diverticular suprapubic recurrences
are arguments for mesh procedures. The fact that all recurrences are located in the area of myo-pectineal and femoral orifices
must be considered for the choice of a mesh procedure. |
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Keywords: | Groin hernia Inguinal hernia Femoral hernia Recurrent hernia |
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