B Romain1, R Chemaly, N Meyer, C Brigand, J P Steinmetz, S Rohr. 1. Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Avenue Molière, 67098, Strasbourg Cedex, France. benoit.romain@chru-strasbourg.fr
Abstract
OBJECTIVE: Strangulated groin hernia is a serious surgical emergency, as it is associated with high morbidity and mortality (2.6-9 %). This retrospective study aimed to find significant prognostic factors of postoperative morbidity and mortality. METHODS: From January 2000 to August 2011, we analyzed all patients who had undergone surgery in emergency for strangulated groin hernia. Forty-nine patients out of 2,917 were operated on strangulated groin hernia in an emergency. RESULTS: The occurrence of strangulated hernia during this period was 1.7 %. Thirty patients out of 49 had inguinal (61.2 %) and 19 femoral (38.8 %) strangulated hernias. The median age was 68.9 years ± 15.3. Patients with strangulated femoral hernia were significantly older than those with inguinal hernia (P = 0.03). There was a significant predominance of men in the inguinal hernia group and a female predominance in the femoral hernia group (P = 0.001). An additional exploration was performed on 12 patients (24.5 %). This exploration was done through a midline laparotomy in 8 patients, a laparoscopy in a single patient and the hernioscopy technique was beneficial in exploring the peritoneal cavity in 3 patients. Intestinal resection was necessary in 10.2 %. In our experience, 50 % of midline laparotomies were performed without any intestinal resection. Fisher's test identified midline laparotomy as the only prognostic factor of postoperative morbidity. CONCLUSION: First intention exploratory laparotomy in strangulated hernia surgery was, in our study, a major cause of postoperative complication.
OBJECTIVE: Strangulated groin hernia is a serious surgical emergency, as it is associated with high morbidity and mortality (2.6-9 %). This retrospective study aimed to find significant prognostic factors of postoperative morbidity and mortality. METHODS: From January 2000 to August 2011, we analyzed all patients who had undergone surgery in emergency for strangulated groin hernia. Forty-nine patients out of 2,917 were operated on strangulated groin hernia in an emergency. RESULTS: The occurrence of strangulated hernia during this period was 1.7 %. Thirty patients out of 49 had inguinal (61.2 %) and 19 femoral (38.8 %) strangulated hernias. The median age was 68.9 years ± 15.3. Patients with strangulated femoral hernia were significantly older than those with inguinal hernia (P = 0.03). There was a significant predominance of men in the inguinal hernia group and a female predominance in the femoral hernia group (P = 0.001). An additional exploration was performed on 12 patients (24.5 %). This exploration was done through a midline laparotomy in 8 patients, a laparoscopy in a single patient and the hernioscopy technique was beneficial in exploring the peritoneal cavity in 3 patients. Intestinal resection was necessary in 10.2 %. In our experience, 50 % of midline laparotomies were performed without any intestinal resection. Fisher's test identified midline laparotomy as the only prognostic factor of postoperative morbidity. CONCLUSION: First intention exploratory laparotomy in strangulated hernia surgery was, in our study, a major cause of postoperative complication.
Authors: V Rodrigues-Gonçalves; M Verdaguer; A Bravo-Salva; M Moratal; R Blanco; F Ochoa-Segarra; J A Pereira-Rodríguez; M López-Cano Journal: Hernia Date: 2022-09-09 Impact factor: 2.920
Authors: Ivan David Lozada-Martinez; Jaime Enrique Covaleda-Vargas; Yuri Alexandra Gallo-Tafur; David Andrés Mejía-Osorio; Andrés Mauricio González-Pinilla; Mayra Alejandra Florez-Fajardo; Fabian Enrique Benavides-Trucco; Julio Cesar Santodomingo-Rojas; Nancy Karol Julieth Bueno-Prato; Alexis Rafael Narvaez-Rojas Journal: Ann Med Surg (Lond) Date: 2022-06-05