A Kohga1, A Kawabe2, T Okumura2, K Yamashita2, J Isogaki2, K Suzuki2. 1. Division of Surgery, Fujinomiya City General Hospital, 3-1, Nishiki-cho, Fujinomiya, Shizuoka, 4180076, Japan. akohga11@yahoo.co.jp. 2. Division of Surgery, Fujinomiya City General Hospital, 3-1, Nishiki-cho, Fujinomiya, Shizuoka, 4180076, Japan.
Abstract
PURPOSE: The feasibility and potential advantages of laparoscopic diagnosis and repair of incarcerated obturator hernia (OH) is debated. The aim of this retrospective study was to compare short-term complications comparing laparoscopic to open repair of OH. METHODS: A total of 29 preoperatively diagnosed patients underwent surgery for a preoperatively diagnosed OH between January 2006 and July 2017. The patients were divided into a laparoscopic group (11 patients underwent laparoscopic repair; 8 without and 3 with intestinal resection) and an open group (18 patients who underwent open repair; 9 without and 9 with intestinal resection).The outcomes were compared between groups. A risk factor analysis for postoperative complications was performed. RESULTS: The incidence of postoperative complications was fewer in the laparoscopic group [9.0% vs. 61.1%; (p < 0.001)]. The bleeding amount [1.2 g vs. 40.4 g; (p = 0.087)] and postoperative length of stay [13.3 days vs. 17.1 days; (p = 0.072)] showed a tendency to be favorable in the laparoscopic group. Occult contralateral OH was detected in three patients (27.7%) in the laparoscopic group and one patient (5.5%) in the open group (p = 0.099). Open surgery and intestinal resection were independent risk factors for a postoperative complication. One patient in the open group developed an incarcerated OH on the contralateral side 1 year after the first surgery. CONCLUSIONS: Laparoscopic repair for incarcerated obturator hernia demonstrated more favorable short-term outcomes compared with open repair in terms of a lower incidence of postoperative complications and it was potentially beneficial for detecting and repairing an occult OH on the contralateral side.
PURPOSE: The feasibility and potential advantages of laparoscopic diagnosis and repair of incarcerated obturator hernia (OH) is debated. The aim of this retrospective study was to compare short-term complications comparing laparoscopic to open repair of OH. METHODS: A total of 29 preoperatively diagnosed patients underwent surgery for a preoperatively diagnosed OH between January 2006 and July 2017. The patients were divided into a laparoscopic group (11 patients underwent laparoscopic repair; 8 without and 3 with intestinal resection) and an open group (18 patients who underwent open repair; 9 without and 9 with intestinal resection).The outcomes were compared between groups. A risk factor analysis for postoperative complications was performed. RESULTS: The incidence of postoperative complications was fewer in the laparoscopic group [9.0% vs. 61.1%; (p < 0.001)]. The bleeding amount [1.2 g vs. 40.4 g; (p = 0.087)] and postoperative length of stay [13.3 days vs. 17.1 days; (p = 0.072)] showed a tendency to be favorable in the laparoscopic group. Occult contralateral OH was detected in three patients (27.7%) in the laparoscopic group and one patient (5.5%) in the open group (p = 0.099). Open surgery and intestinal resection were independent risk factors for a postoperative complication. One patient in the open group developed an incarcerated OH on the contralateral side 1 year after the first surgery. CONCLUSIONS: Laparoscopic repair for incarcerated obturator hernia demonstrated more favorable short-term outcomes compared with open repair in terms of a lower incidence of postoperative complications and it was potentially beneficial for detecting and repairing an occult OH on the contralateral side.
Authors: Jae Seung Kwak; Sang Eok Lee; Si Min Park; Seung Jae Lee; Seong Uk Kwon; In Eui Bae; Nak Song Sung; Ju Ik Moon; Dae Sung Yoon; In Seok Choi; Won Jun Choi Journal: J Minim Invasive Surg Date: 2020-06-15