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Comparative Study
. 2015 Dec;29(12):3741-9.
doi: 10.1007/s00464-015-4149-2. Epub 2015 Mar 19.

Do we need antibiotic prophylaxis in endoscopic inguinal hernia repair? Results of the Herniamed Registry

F Köckerling  1 , R Bittner  2 , D Jacob  3 , C Schug-Pass  3 , C Laurenz  3 , D Adolf  4 , T Keller  4 , B Stechemesser  5
Affiliations
Comparative Study

Do we need antibiotic prophylaxis in endoscopic inguinal hernia repair? Results of the Herniamed Registry

F Köckerling et al. Surg Endosc. 2015 Dec.

Abstract

Introduction: The use of antibiotic prophylaxis in inguinal hernia repair is a controversial issue. Accepted randomized controlled trials or registry data with specific analysis of endoscopic repaired patients do not exist.

Patient and methods: The data presented in this study compared the prospectively collected data from the Herniamed Registry on all patients who had undergone unilateral, bilateral or recurrent repair of inguinal hernias using either endoscopic or open techniques between September 1, 2009, and March 5, 2014. In total, 85,033 patients were enrolled. Of these patients, 48,201 (56.7 ) had an endoscopic and 36,832 (43.3%) an open repair. The target variables analyzed were impaired wound healing and deep infections with mesh involvement within 30 days after the operation.

Results: Analysis of the patient group with endoscopic/laparoscopic inguinal hernia repair (n = 48,201) did not identify any significant influence of antibiotic prophylaxis on postoperative impaired wound healing, which occurred in 53 cases (p = 0.6431). Nor was it possible to identify any significant impact of antibiotic prophylaxis on the deep infections seen in 27 cases (p = 0.8409). Analysis of the open inguinal hernia repair group revealed that, unlike the laparoscopic/endoscopic group, antibiotic prophylaxis had a significant impact on the postoperative impaired wound healing and deep infection rates. The risk of postoperative impaired wound healing with antibiotic prophylaxis was significantly lower [OR 0.677 (0.479; 0.958), p = 0.027].

Conclusion: The positive impact of the endoscopic/laparoscopic technique on avoidance of impaired wound healing and deep infections with mesh involvement is already so great that antibiotic prophylaxis has no additional benefit. In contrast, antibiotic prophylaxis should be administered for open inguinal hernia repair.

Keywords: Antibiotic prophylaxis; Endoscopic inguinal hernia repair; Postoperative complications; TAPP; TEP; Wound infection.

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References

    1. Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Koeckerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Condes S, Reinpold W, Rosenberg J, Sauerland S, Schug-Pass C, Singh K, Timoney M, Weyhe D, Chowbey P. Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)] Surg Endosc. 2011;25(9):2773–2843. doi: 10.1007/s00464-011-1799-6. - DOI - PMC - PubMed
    1. Bittner R, Schmedt CG, Schwarz J, Kraft K, Leible BJ. Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg. 2002;89(8):1062–1066. doi: 10.1046/j.1365-2168.2002.02178.x. - DOI - PubMed
    1. Tamme C, Scheidbach H, Hampe C, Schneider C, Köckerling F. Totally extraperitoneal endoscopic inguinal hernia repair (TEP) Surg Endosc. 2003;17:190–195. doi: 10.1007/s00464-002-8905-8. - DOI - PubMed
    1. Schwetling R, Bärlehner E. Is there an indication for general perioperative antibiotic prophylaxis in laparoscopic plastic hernia repair with implantation of alloplastic tissue? Zentralbl Chir. 1998;123(2):193–195. - PubMed
    1. Stechemesser B, Jacob DA, Schug-Paß C, Köckerling F. Herniamed: an internet-based registry for outcome research in hernia surgery. Hernia. 2012;16(3):269–276. doi: 10.1007/s10029-012-0908-3. - DOI - PubMed

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