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Cesarean Section and Simultaneous Hernia Repair
Nicole Ochsenbein-Kölble, MD;
Nicolas Demartines, MD;
Nadin Ochsenbein-Imhof, MD;
Roland Zimmermann, MD
Arch Surg. 2004;139:893-895.
Hypothesis The combination of cesarean section with inguinal or umbilical hernia repair is safe, effective, and well-accepted compared with cesarean section alone.
Design Retrospective comparative study.
Setting Tertiary care university hospital.
Patients Eight patients undergoing cesarean section combined with hernia repair (inguinal in 5 and umbilical in 3) vs 305 low-risk patients undergoing cesarean section alone.
Main Outcome Measures Operation time, blood loss, opiate use, peripartum complications, hospital stay, hernia recurrence, and patient impression.
Results The combined procedure took significantly longer than cesarean section alone in the case of inguinal but not umbilical hernia. There were no major complications. Wound healing was delayed, without infection, in 1 patient with an inguinal hernia. Blood loss, opiate use, and hospital stay did not differ significantly from those of controls. No hernia recurred after a mean observation period of 56 months. Seven of the 8 patients reported that they would recommend the combined operation.
Conclusions Combined cesarean section and hernia repair avoids rehospitalization for separate hernia repair. With a single incision (in the case of inguinal hernia repair), single anesthesia, and single hospital stay, the combined procedure confers valuable advantages for both patient and hospital in time, cost, and convenience, not to mention avoiding the separation of mother from newborn entailed by reoperation. Our results in a pilot group indicate that the combination approach is safe, effective, and well accepted. Confirmation in a larger population should establish it as a recommendable procedure.
From the Departments of Obstetrics (Drs Ochsenbein-Kölble, Ochsenbein-Imhof, and Zimmermann) and Surgery (Dr Demartines), University Hospital, Zurich, Switzerland.
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