Inguino-crural hernias. The problem of recurrence

Experience of the surgical treatment of inguinal hernias is reported. From 1971 to 1987, 472 patients (mean age 53.7 yrs., min. 2-max. 92 yrs.) had been operated on to repair 543 hernias. They were O.E. in 348 cases, O.I. in 10, direct in 175 and crural in 10. Five-hundred-nine (93.7%) were operated electively (48 due to recurrence) and 34 in emergency (6 due to recurrence). General anesthesia was used in 95.9% of cases, local in 3% and spinal in 1.1%. Bassini's technique was used in 510 cases, Postemsky's in 23 and Ruggi's in 10. A non-reabsorbable suture was carried out in 78.8% of herniorraphies. Operative mortality was 0.4% (2 pts.) and morbidity due to minor complications 15.8%. At a mean follow-up of 59 months (min. 3-max. 195 mo.), 80.7% of patients (#82.3% of hernias) have been controlled. Fifteen recurrences have been noted. All recurrent hernias had been electively operated and their recurrence verified not later that 7 years after operation (min. 3-max. 84, mean 25 mo.). The type of hernia, surgical technique, anaesthesia, suture material, associated operation, early or late mobilization of the patient, postoperative complications, the time range from operation to recurrence and the surgeon's experience were the subject of statistical comparison. Only the latter showed statistical significance (p < 0.05) pointing to the experience and ability of operator as the most important factor in recurrence.