Crosslinking Surgical Oncology and the Assessments of Hernia Sac Tissues With Malignant Transformations.

BACKGROUND

Hernia repairs are performed frequently, yet studies investigating the presence of malignancies within hernia sac tissues during these operations remain limited. The research investigated histopathological changes in hernia sac tissues, along with early signs of malignancy, while integrating surgical oncology practices with diagnostic pathological examinations.

METHODS

This prospective observational study included 100 adult patients who underwent abdominal surgery between January and September 2022. Eighty candidates undergoing elective hernia repair surgery participated in this study, along with 20 patients with age and sex similarities undergoing unrelated abdominal surgeries. Sample size was calculated using OpenEpi software version 3.0.0 (Dean, Sullivan, Soe: Atlanta, GA). General evaluation of the hernia sac tissue involved the examination of chronic inflammation, mesothelial hyperplasia, atypical cellular changes, fibrosis, and vascular proliferation. Statistical analysis was done using SPSS version 26 (Armonk, NY: IBM Corp.) with a p-value of <0.05 considered statistically significant.

RESULTS

Out of the total participants in the hernia group, 34 (42.5%) showed chronic inflammatory infiltration, while 17 (21.3%) exhibited mesothelial hyperplasia. Early atypical cellular architecture, suspicious for neoplastic transformation, was found in six cases (7.5%). Pathological analysis revealed that subjects from the hernia group presented with significantly higher rates of fibrotic thickening (p=0.021), vascular changes (p=0.034), and cellular atypia (p=0.011). All samples collected from the control group demonstrated no signs of malignant development.

CONCLUSION

The analysis of hernia sac tissue showed early signs that indicate potential pre-malignant changes under specific circumstances. Due to its capacity to spot early signs of cancer, the routine practice of microscopic evaluation enables better disease monitoring in surgical patients.