Modification to the Lloyd Milton Nyhus’s Classification upon Adding the Variable Reducibility

Abstract

Introduction: Classifications of abdominal wall hernias allow us to group them homogeneously and thus compare the results of different studies. Many have been described with the use of several variables, but none can meet all the expectations for which they were created.

Objective: To present our modification to the original Lloyd Milton Nyhus’s classification by adding the variable reducibility for the stratification of inguinocrural hernias.

Methods: A descriptive and prospective study was carried out, in the period from January 2018 to December 2019, in 449 patients with hernia of the inguinocrural region treated at Dr. Juan Bruno Zayas Alfonso University Hospital of Santiago de Cuba. The data were obtained from an Electronic Registry of Hernias created in the statistical processor Epi info (version 3.5.4), as well as presented then in tables and percentages.

Results: The new nomenclature to identify the different subgroups of hernias was presented. It was obtained that 85.3% had reducible hernias, 1.5% had incarcerated hernias, 9.3% had stuck hernias and 1.7% had strangulated hernias. With this new classification, we have, in our Hernia Registry, all the clinical subgroups of hernias in the inguinocrural region.

Conclusions: The new modification allows us to stratify and compare patients homogeneously by subgroups; it is easy to use and of great care-related, teaching and scientific value.

Keywords: classification; reducibility; irreducibility; complicated abdominal hernias.