Inguinal hernias are common in patients with decompensated liver cirrhosis and ascites, being associated with a higher risk of complications. The optimal surgical technique remains a matter of debate. This prospective study included 42 patients with decompensated cirrhosis and unilateral inguinal hernia, divided into two equal groups: Group I – traditional tissue repair (21 patients) and Group II – Lichtenstein mesh repair (21 patients). All patients underwent preoperative paracentesis and intra-abdominal pressure measurement. Outcomes included operative time, early postoperative complications, length of hospital stay, 30-day mortality, 12-month recurrence, and quality of life (SF-36 questionnaire). Mean operative time was similar between the two groups (65 vs 63 minutes, p=0.42). Early postoperative complications were minimal and not significantly different (p=0.19). Mean hospital stay was shorter in Group II (3 vs 5 days, p=0.03). No postoperative mortality was recorded. At 12 months, hernia recurrence occurred in 2 patients from Group I (9.5%) and in none from Group II (p=0.04). Quality of life improved in both groups, with higher scores in the Lichtenstein group (p=0.02). Elective inguinal hernia repair in patients with decompensated cirrhosis and ascites is safe when preceded by adequate preoperative preparation. The Lichtenstein technique provides superior outcomes compared to tissue repair, reducing recurrence and hospital stay while maintaining a favorable safety profile.
Pisarenco et al. (Wed,) studied this question.
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