Challenging a surgical dictum: results from a 10-year experience on the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy

C. C H Stucky, E. M. Garvey, D. J. Johnson, A. B. Chapital, C. M. Gossage, Nabil Wasif, K. L. Harold

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Results: One hundred and fifty-eight patients were on chronic warfarin therapy. Of these, 40 patients (25 %) continued on warfarin during the perioperative period (CW). Average preoperative international normalized ratio (INR) was 2.15 ± 0.76 for CW and 1.38 ± 0.42 for DW, p < 0.001. Mean operative times were equivalent between all three groups (88 min CW vs. 85 min DW vs. 79 min C, p = 0.518). Although CW patients experienced higher incidences of both hematoma and urinary retention overall, no statistically significant differences in complication rates were seen between the three groups (hematoma = 10 vs. 8 % DW vs. 5 % C, p = 0.703; urinary retention = 15 vs. 10 % DW vs. 8 % C, p = 0.541). Comparing patients by INR, there were no statistically different postoperative complication rates, particularly for hematoma (8 % INR <2 vs. 9.5 % INR = 2–3 vs. 20 % INR >3, p = 0.65).

Conclusion: Maintenance of warfarin therapy during the perioperative period for open inguinal herniorrhaphy results in equivalent operative times and postoperative complications as discontinuation.

Methods: A retrospective review of 1,839 consecutive patients undergoing open inguinal hernia repair was conducted from 2000 to 2010. All patients on chronic warfarin therapy were included. Three groups: continuation (CW), discontinuation (DW) and case-matched control (C) not on warfarin therapy were compared for operative details and postoperative complications.

Background: Previous reports document the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy; however, the practice remains controversial. This study is a 10-year update of our experience.

Original languageEnglish (US)
Pages (from-to)83-87
Number of pages5
JournalHernia
Volume19
Issue number1
DOIs
StatePublished - 2015

Fingerprint

Groin
Herniorrhaphy
Warfarin
Safety
Perioperative Period
Therapeutics
International Normalized Ratio
Inguinal Hernia
Operative Time
Maintenance

Keywords

  • Anticoagulation
  • Inguinal hernia
  • Warfarin

ASJC Scopus subject areas

  • Surgery

Cite this

Challenging a surgical dictum : results from a 10-year experience on the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy. / Stucky, C. C H; Garvey, E. M.; Johnson, D. J.; Chapital, A. B.; Gossage, C. M.; Wasif, Nabil; Harold, K. L.

In: Hernia, Vol. 19, No. 1, 2015, p. 83-87.

Research output: Contribution to journalArticle

Stucky, C. C H ; Garvey, E. M. ; Johnson, D. J. ; Chapital, A. B. ; Gossage, C. M. ; Wasif, Nabil ; Harold, K. L. / Challenging a surgical dictum : results from a 10-year experience on the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy. In: Hernia. 2015 ; Vol. 19, No. 1. pp. 83-87.
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abstract = "Results: One hundred and fifty-eight patients were on chronic warfarin therapy. Of these, 40 patients (25 {\%}) continued on warfarin during the perioperative period (CW). Average preoperative international normalized ratio (INR) was 2.15 ± 0.76 for CW and 1.38 ± 0.42 for DW, p < 0.001. Mean operative times were equivalent between all three groups (88 min CW vs. 85 min DW vs. 79 min C, p = 0.518). Although CW patients experienced higher incidences of both hematoma and urinary retention overall, no statistically significant differences in complication rates were seen between the three groups (hematoma = 10 vs. 8 {\%} DW vs. 5 {\%} C, p = 0.703; urinary retention = 15 vs. 10 {\%} DW vs. 8 {\%} C, p = 0.541). Comparing patients by INR, there were no statistically different postoperative complication rates, particularly for hematoma (8 {\%} INR <2 vs. 9.5 {\%} INR = 2–3 vs. 20 {\%} INR >3, p = 0.65).Conclusion: Maintenance of warfarin therapy during the perioperative period for open inguinal herniorrhaphy results in equivalent operative times and postoperative complications as discontinuation.Methods: A retrospective review of 1,839 consecutive patients undergoing open inguinal hernia repair was conducted from 2000 to 2010. All patients on chronic warfarin therapy were included. Three groups: continuation (CW), discontinuation (DW) and case-matched control (C) not on warfarin therapy were compared for operative details and postoperative complications.Background: Previous reports document the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy; however, the practice remains controversial. This study is a 10-year update of our experience.",
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AU - Garvey, E. M.

AU - Johnson, D. J.

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AU - Wasif, Nabil

AU - Harold, K. L.

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N2 - Results: One hundred and fifty-eight patients were on chronic warfarin therapy. Of these, 40 patients (25 %) continued on warfarin during the perioperative period (CW). Average preoperative international normalized ratio (INR) was 2.15 ± 0.76 for CW and 1.38 ± 0.42 for DW, p < 0.001. Mean operative times were equivalent between all three groups (88 min CW vs. 85 min DW vs. 79 min C, p = 0.518). Although CW patients experienced higher incidences of both hematoma and urinary retention overall, no statistically significant differences in complication rates were seen between the three groups (hematoma = 10 vs. 8 % DW vs. 5 % C, p = 0.703; urinary retention = 15 vs. 10 % DW vs. 8 % C, p = 0.541). Comparing patients by INR, there were no statistically different postoperative complication rates, particularly for hematoma (8 % INR <2 vs. 9.5 % INR = 2–3 vs. 20 % INR >3, p = 0.65).Conclusion: Maintenance of warfarin therapy during the perioperative period for open inguinal herniorrhaphy results in equivalent operative times and postoperative complications as discontinuation.Methods: A retrospective review of 1,839 consecutive patients undergoing open inguinal hernia repair was conducted from 2000 to 2010. All patients on chronic warfarin therapy were included. Three groups: continuation (CW), discontinuation (DW) and case-matched control (C) not on warfarin therapy were compared for operative details and postoperative complications.Background: Previous reports document the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy; however, the practice remains controversial. This study is a 10-year update of our experience.

AB - Results: One hundred and fifty-eight patients were on chronic warfarin therapy. Of these, 40 patients (25 %) continued on warfarin during the perioperative period (CW). Average preoperative international normalized ratio (INR) was 2.15 ± 0.76 for CW and 1.38 ± 0.42 for DW, p < 0.001. Mean operative times were equivalent between all three groups (88 min CW vs. 85 min DW vs. 79 min C, p = 0.518). Although CW patients experienced higher incidences of both hematoma and urinary retention overall, no statistically significant differences in complication rates were seen between the three groups (hematoma = 10 vs. 8 % DW vs. 5 % C, p = 0.703; urinary retention = 15 vs. 10 % DW vs. 8 % C, p = 0.541). Comparing patients by INR, there were no statistically different postoperative complication rates, particularly for hematoma (8 % INR <2 vs. 9.5 % INR = 2–3 vs. 20 % INR >3, p = 0.65).Conclusion: Maintenance of warfarin therapy during the perioperative period for open inguinal herniorrhaphy results in equivalent operative times and postoperative complications as discontinuation.Methods: A retrospective review of 1,839 consecutive patients undergoing open inguinal hernia repair was conducted from 2000 to 2010. All patients on chronic warfarin therapy were included. Three groups: continuation (CW), discontinuation (DW) and case-matched control (C) not on warfarin therapy were compared for operative details and postoperative complications.Background: Previous reports document the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy; however, the practice remains controversial. This study is a 10-year update of our experience.

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