Bilateral inguinal hernioplasty in emergency surgery: Is it feasible? Comparative retrospective study using “propensity score matching”

Abstract

INTRODUCTION: Hernias, particularly groin hernias, are prevalent surgical pathologies worldwide, often necessitating surgery in cases of complications. This study investigates the safety and efficacy of performing bilateral inguinal hernioplasty when one side faces complications, addressing the lack of consensus in emergency groin hernia treatment. MATERIALS AND METHODS: A retrospective, single-center study spanning a duration of 10 years was conducted, including adult patients who underwent emergency surgery for inguinal hernia. Propensity score matching was employed to create similar groups for comparative analysis of unilateral versus bilateral emergency groin hernioplasty. Surgical techniques, complications, mortality, and long-term outcomes were evaluated. RESULTS: This study included 341 patients. Data obtained from the study revealed high morbidity and 90-day mortality rates, consistent with the data of existing literature. Propensity score matching yielded two comparable groups. Short-term outcomes showed no significant differences in complication rates, mortality, surgical site infection, or hospital stay between unilateral and bilateral hernioplasty groups. Bilateral surgery takes approximately 15 min of the procedure time. Long-term outcomes exhibited similar recurrence rates between groups. CONCLUSION: This study supports the practice of bilateral inguinal hernioplasty in emergency scenarios when one side faces complications. It is a safe approach without any significant increase in morbidity or hospital stay, while reducing the need for a subsequent intervention and its associated risks and costs. Further prospective research is necessary to confirm these findings.

Keywords

• bilateral hernia repair
• emergency hernia repair
• hernia surgery
• open posterior hernia repair