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, N. Wasif, K. L. Harold

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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.

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.

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

Keywords

  • Anticoagulation
  • Inguinal hernia
  • Warfarin

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Challenging a surgical dictum: results from a 10-year experience on the safety of open inguinal herniorrhaphy in patients on chronic warfarin therapy'. Together they form a unique fingerprint.

Cite this