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Suture repair versus mesh repair in elderly populations with incarcerated or strangulated groin hernia

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Abstract

Tension-free hernia repair is the gold standard for groin hernia repair. However, the optimal surgical treatment for incarcerated or strangulated groin hernia in elderly populations is controversial. The aim of this study is to compare the clinical efficacy of mesh repair and suture repair in the treatment of incarcerated or strangulated groin hernia in elderly patients. Patients ≥ 65 years who underwent urgent surgical repair for incarcerated or strangulated groin hernia from January 2012 to June 2022 were included. Patients’ demographic data and postoperative outcomes were retrospectively analyzed. Patients with limited life expectancy were screened from the elderly population for subgroup analysis. A total of 103 patients (median age: 84 years old, range 65–96; mean follow-up time: 36.8 ± 24.8 months) were included, involving 42 cases in the suture repair group and 61 cases in the mesh repair group. Suture repair and mesh repair had similar lengths of ICU and hospital stay, and rates of small bowel resection, chronic pain, surgical site infection, and surgical-related death. However, suture repair had a significantly higher recurrence rate than mesh repair (7% vs. 2%, P = 0.04). In our subgroup analysis, for patients with limited life expectancy (41 patients; median age: 88 years old, range: 80–96), suture repair had no statistical difference in postoperative outcomes compared with mesh repair. Mesh repair is suitable for elderly patients with acutely incarcerated or strangulated groin hernias. However, for elderly patients with limited life expectancy, suture repair and mesh repair showed similar clinical outcomes.

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Data proceed in this article are available from the corresponding author.

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Acknowledgements

There are no acknowledgments.

Funding

This work is supported by the National Natural Science Foundation of China (Number: 81970455, 82170526).

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Author notes

  1. Hekai Shi and Shaochun Li contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Fudan University Affiliated Huadong Hospital, No. 221, West Yan’an Road, Jing’an District, Shanghai, 200040, People’s Republic of China

    Hekai Shi, Shaochun Li, Yiming Lin, Dongchao Yang, Wenpei Dong, Zhicheng Song, Heng Song & Yan Gu

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  1. Hekai Shi
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  2. Shaochun Li
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  3. Yiming Lin
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  7. Heng Song
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  8. Yan Gu
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Contributions

Conceptualization, HS and SL; methodology, HS; validation, YL, DY, HS, and WD; formal analysis, HS and SL; investigation, HS, and ZS; data curation, HS and SL; writing—original draft preparation, HS; writing—review and editing, YG; visualization, HS; supervision, YG; project administration, YG. All the authors have read and agreed to the published version of the manuscript.

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Correspondence to Yan Gu.

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Conflict of interest

There are no conflicts of competing interests.

Ethical approval

Ethical approval was approved by the Ethics Committee of the Huadong Hospital.

Research involving human participants and/or animals

All procedures performed in this study involving human participants were in accordance with the ethical standards of the ethical committee of Huadong Hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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For this type of study, informed consent is waived.

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This manuscript has not been published or presented elsewhere in part or entirety and is not under consideration by another journal. All the authors had thoroughly reviewed the manuscript and approved the submission.

Registration number

This study was retrospectively registered at clinicaltrials.gov (ID: NCT05966285).

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Shi, H., Li, S., Lin, Y. et al. Suture repair versus mesh repair in elderly populations with incarcerated or strangulated groin hernia. Updates Surg (2024). https://doi.org/10.1007/s13304-023-01745-8

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