Abstract
Purpose
Compared with other types of hernia, femoral hernias in adults are less common and we have had little literature about femoral hernia. The purpose of this study was to evaluate the incidence of femoral hernias in adults and to analyze the characteristics of femoral hernias.
Methods
This retrospective study was based on the medical records of 60 patients who underwent herniorrhaphies for treating femoral hernia in adults from January 2001 to December 2007. We analyzed the incidence of femora hernias, the symptoms, the operative techniques, the complications, the mortality and the postoperative recurrence rates.
Results
The incidence of femoral hernia was 4.6% in all cases of inguinal hernias. The incidence in females was about 4 times higher than in males (P<0.001). The most common symptom was bulging. The operative technique was changed from plug technique to bilayer technique. Seroma including swelling and pain were prominent complications. We experienced one case of mortality.
Conclusion
Femoral hernia is a rare type of inguinal hernia in adult. Femoral hernia is more frequent in females and in the aged; it is an important surgical pathology with high rate of incarceration or strangulation. In consideration of the pathology of hernia and difficulty of the peri-operative diagnosis, the Prolene Hernia System herniorrhaphy is a superior method to other methods in femoral hernia.
Figures and Tables
References
1. Lichtenstein IL. Herniorrhaphy. A personal experience with 6,321 cases. Am J Surg. 1987. 153:553–559.
2. Gilbert AI. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia. Am J Surg. 1989. 157:331–333.
3. Chevrel JP, editor. Hernias and Surgery of the Abdominal Wall. 1998. 2nd rev. ed. Berlin: Springer;175–178.
4. Bellon JM, Bujan J, Honduvilla NG, Jurado F, Gimeno MJ, Turnay J, et al. Study of biochemical substrate and role of metalloproteinases in fascia transversalis from hernial processes. Eur J Clin Invest. 1997. 27:510–516.
5. Read RC. Fitzgibbons RJ, Greenburg AG, Nyhus LM, editors. Why do human beings develop groin hernias? Nyhus and Condon's Hernia. 2002. 5th ed. Philadelphia: Lippincott Williams & Wilkins;3–7.
6. Jung SW, Heo TG, Lee JM, Choi PW, Park JH, Lee MS, et al. Clinical analysis of 473 cases of inguinal hernia in adult patients. J Korean Surg Soc. 2008. 75:109–115.
7. Naude GP, Ocon S, Bongard F. Femoral hernia: the dire consequences of a missed diagnosis. Am J Emerg Med. 1997. 15:680–682.
8. Bekoe S. Prospective analysis of the management of incarcerated and strangulated inguinal hernias. Am J Surg. 1973. 126:665–668.
9. Brasso K, Londal Nielsen K, Christiansen J. Long-term results of surgery for incarcerated groin hernia. Acta Chir Scand. 1989. 155:583–585.
10. Glassow F. Femoral hernia. Review of 2,105 repairs in a 17 year period. Am J Surg. 1985. 150:353–356.
11. Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G, et al. Femoral hernia: a review of 83 cases. Hernia. 2006. 10:70–73.
12. Oishi SN, Page CP, Schwesinger WH. Complicated presentations of groin hernias. Am J Surg. 1991. 162:568–570.
13. Malangoni MA, Rosen MJ. Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Hernia. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 2008. 18th ed. Philadelphia: Saunders Elsevier;1155–1179.
14. Kim HC, Chung M. 120 cases of hernia repair with bilayer patch (prolene hernia system). J Korean Surg Soc. 2006. 70:204–208.
15. Lee YT, Yang YS, Lee YJ, Ko SJ. A tension-free herniorrhaphy using the prolene hernia system: clinical experiences. J Korean Surg Soc. 2008. 74:361–365.
16. Gilbert AI, Graham MF, Voigt WJ. A bilayer patch device for inguinal hernia repair. Hernia. 1999. 3:161–166.