Turgay KARATAS, Davut OZBAG, Murat KANLİOZ

Retrospective analysis of inguinofemoral hernias

We aim to present the operative findings of inguinal and femoral hernias that were operated.The records of 732 patients who underwent surgery for inguinal and femoral hernia between March 2000 and January 2013 were evaluated retrospectively. The number, sex, and age of patients, type and side of hernias, the existence of strangula-tion, structure, and content of hernia sac were recorded.684 (93.4 %) of patient is male, 48 (6.5 %) of patient is female. The average age was 46.2. The rate of inguinal hernia was 96.7 %. However, the rate of femoral hernia was 3.2 %. Inguinal hernia 97.9 % and femoral hernia 2 % was found among males. Inguinal hernia 79.1 % and femoral hernia 20 % was found among females. Indirect hernia rates were 70.4 % among males and 75 % among females. Direct hernia rates were 20.7 % among males and 4.1 % among females. Hernias were located in 59 % on right-side, in 37 % on left-side, in 3.1 % on bilateral. The strangulated hernia was seen at 3.1 % in all cases. Strangulation rate was higher among women (6.2 % - 2.9 %). The strangulation rate was 16.6 % in femoral hernia, but this ratio was 2.6 % in inguinal hernia. Hernia sac consisted of peritoneum frequently (99.4 %). The structure that was found mostly in hernia sac was omentum majus (40.4 %).Inguinal hernias are encountered more than femoral hernias. The strangulation rate in femoral hernias is higher than in inguinal hernias. Since the strangulation rate is higher in femoral hernias, the surgical urgency of this type of hernias is higher than inguinal hernias. At the same time, because the internal organs can form the hernia sac or the organ inside the sac, the surgeon should pay maximum attention during the operation.

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1. Jenkins J T, O’Dwyer P J. Inguinal hernias. BMJ. 2008; 336:269-72.

2. Rutkow IM. A selective history of groin hernia surgery in the early 19. century:The anatomic atlases of Astley Cooper, Franz Hesselbach, Antonio Scarpa, and Jules-Germain Cloquet. Surg Clin North Am. 1998;78:921-40.

3. Gallegos NC, Dawson J, Jarvis M, et al. Risk of strangulation in groin hernias. Br J Surg. 1991;78:1171-3.

4. Hachisuka T. Femoral hernia repair. Surg Clin North Am. 2003;83:1189-205.

5. van Wessem KJ, Simons MP, Plaisier PW, et al. The etiology of indirect inguinal hernias: congenital and/or acquired?. Hernia. 2003;7:76-9.

6. Ertaş E, Polat KY, Bulut T, et al. Hydroxyproline levels in rectus sheat in inguinal hernias. Türkiye Klinikleri J Med Res. 1991;9:395-7.

7. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009; 13:343-403.

8. Fruchaud H. Anatomie chirurgicale des Hernies de I’ Aline. Paris: C. Doin. 1956

9. Towsend CM, Evers BM, Beauchamp RD, et al. Sabiston Textbook of Surgery-Modern Cerrahi Pratiğin Biyolojik Temeli. Çeviri Ed: Ali Naki Ulusoy. In:Herniler. Nobel Tıp Kitabevleri Ltd. Şti, İstanbul, 2010;1199-218

10. Ponka JL (ed): Hernias of the abdominal wall. W.B. Saunders, Philadelphia, 1980:2-90.

11. Coley WB. I. Result of One Thousand Operations for the Radical Cure of Inguinal and Femoral Hernia. Ann Surg. 1903;37:801-24.

12. Erdman S. Inguinal hernia in the male: late results in 978 traced cases. Ann Surg. 1923;77:171-89.

13. Fallis LS. Inguinal Hernia: a report of 1600 operations. Ann Surg. 1936; 104:403-18.