M Yildirim1, F Dasiran2, Y S Angin2, I Okan2. 1. Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Sevki Erek Yerleskesi, 60030, Tokat, Turkey. dryildirim40@yahoo.com. 2. Department of General Surgery, Faculty of Medicine, Gaziosmanpasa University, Sevki Erek Yerleskesi, 60030, Tokat, Turkey.
Abstract
PURPOSE: The purpose of this study was to investigate whether it is possible to estimate systemic inflammation and intestinal ischemia in incarcerated hernias using the lymphocyte-C-reactive protein ratio (LCR). METHODS: A total of 116 patients who underwent an emergency operation due to incarcerated abdominal wall hernia were investigated retrospectively. The patients with incarcerated hernias were divided into two groups: those who did not undergo intestinal resection and those who underwent intestinal resection due to strangulation. The two groups were analyzed based on sex, surgical operation (open, laparoscopic), length of stay, complications and mortality rates as well as preoperative period laboratory analyses, such as white blood cell, neutrophil, thrombocyte, and lymphocyte counts and C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR) and LCR values. RESULTS: Twenty-five patients (21.6%) underwent intestinal resection due to strangulated hernia. Neutrophil count, lymphocyte count, CRP, platelet count, NLR, and LCR were significantly different in the strangulated hernia group. Receiver operating characteristic (ROC) analysis results showed that an LCR level below 0.02 had 80% sensitivity (58-92%) and 80.2% specificity (70-87%) for the diagnosis of strangulation. CONCLUSION: A low preoperative LCR level in incarcerated hernias could be used as a bioindicator that helps to estimate the intestinal ischemia.
PURPOSE: The purpose of this study was to investigate whether it is possible to estimate systemic inflammation and intestinal ischemia in incarcerated hernias using the lymphocyte-C-reactive protein ratio (LCR). METHODS: A total of 116 patients who underwent an emergency operation due to incarcerated abdominal wall hernia were investigated retrospectively. The patients with incarcerated hernias were divided into two groups: those who did not undergo intestinal resection and those who underwent intestinal resection due to strangulation. The two groups were analyzed based on sex, surgical operation (open, laparoscopic), length of stay, complications and mortality rates as well as preoperative period laboratory analyses, such as white blood cell, neutrophil, thrombocyte, and lymphocyte counts and C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR) and LCR values. RESULTS: Twenty-five patients (21.6%) underwent intestinal resection due to strangulated hernia. Neutrophil count, lymphocyte count, CRP, platelet count, NLR, and LCR were significantly different in the strangulated hernia group. Receiver operating characteristic (ROC) analysis results showed that an LCR level below 0.02 had 80% sensitivity (58-92%) and 80.2% specificity (70-87%) for the diagnosis of strangulation. CONCLUSION: A low preoperative LCR level in incarcerated hernias could be used as a bioindicator that helps to estimate the intestinal ischemia.
Authors: Kemal Eyvaz; Onur Ilkay Dincer; Murat Kazim Kazan; Aydın Dincer; Arif Aslaner; Aylin Acar; Tugrul Cakir Journal: North Clin Istanb Date: 2021-12-31