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Laparoscopic repair is a treatment of choice for selected patients with incarcerated obturator hernia

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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.

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References

  1. Chang SS, Shan YS, Lin YJ, Tai YS, Lin PW (2005) A review of obturator hernia and a proposed algorithm for its diagnosis and treatment. World J Surg 29:450–454

    Article  PubMed  Google Scholar 

  2. Petrie A, Tubbs RS, Matusz P, Shaffer K, Loukas M (2011) Obturator hernia: anatomy, embryology, diagnosis, and treatment. Clin Anat 24:562–569

    Article  PubMed  Google Scholar 

  3. Susmallian S, Ponomarenko O, Barnea R, Paran H (2016) Obturator hernia as a frequent finding during laparoscopic pelvic exploration: a retrospective observational study. Medicine (Baltimore) 95:e4102. https://doi.org/10.1097/MD.0000000000004102

    Article  Google Scholar 

  4. Kulkarni SR, Punamiya AR, Naniwadekar RG, Janugade HB, Chotai TD, Vimal Singh T, Natchair A (2013) Obturator hernia: a diagnostic challenge. Int J Surg Case Rep 4:606–608

    Article  PubMed  PubMed Central  Google Scholar 

  5. Zhang H, Cong JC, Chen CS (2010) Ileum perforation due to delayed operation in obturator hernia: a case report and review of literatures. World J Gastroenterol 16:126–130

    PubMed  PubMed Central  Google Scholar 

  6. Ng DC, Tung KL, Tang CN, Li MK (2014) Fifteen-year experience in managing obturator hernia: from open to laparoscopic approach. Hernia 18:381–386

    Article  CAS  PubMed  Google Scholar 

  7. Ramser M, Messmer AS, Zbinden I, Von Holzen U, Nebiker CA (2014) Incarcerated obturator hernia-laparoscopic repair with intraoperative view of the corona mortis. J Surg Case Rep. https://doi.org/10.1093/jscr/rju081

    Article  PubMed  PubMed Central  Google Scholar 

  8. Otowa Y, Kanemitsu K, Sumi Y, Nakamura T, Suzuki S, Kuroda D, Kakeji Y (2014) Laparoscopic trans-peritoneal hernioplasty (TAPP) is useful for obturator hernias: report of a case. Surg Today 44:2187–2190

    Article  PubMed  Google Scholar 

  9. Hayama S, Ohtaka K, Takahashi Y, Ichimura T, Senmaru N, Hirano S (2015) Laparoscopic reduction and repair for incarcerated obturator hernia: comparison with open surgery. Hernia 19:809–814

    Article  CAS  PubMed  Google Scholar 

  10. Liu J, Zhu Y, Shen Y, Liu S, Wang M, Zhao X, Nie Y, Chen J (2017) The feasibility of laparoscopic management of incarcerated obturator hernia. Surg Endosc 31:656–660. https://doi.org/10.1007/s00464-016-5016-5

    Article  PubMed  Google Scholar 

  11. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  12. Leitch MK, Yunaev M (2016) Difficult diagnosis: strangulated obturator hernia in an 88-year-old woman. BMJ Case Rep. https://doi.org/10.1136/bcr-2016-215428

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ghosheh B, Salameh JR (2007) Laparoscopic approach to acute small bowel obstruction: review of 1061 cases. Surg Endosc 21(11):1945–1949

    Article  PubMed  Google Scholar 

  14. O’Connor DB, Winter DC (2012) The role of laparoscopy in the management of acute small-bowel obstruction: a review of over 2000 cases. Surg Endosc 26:12–17

    Article  PubMed  Google Scholar 

  15. Kohga A, Kawabe A, Hasegawa Y, Yajima K, Okumura T, Yamashita K, Isogaki J, Suzuki K, Komiyama A (2017) Ileo-ileal intussusception caused by lymphangioma of the small bowel treated by single-incision laparoscopic-assisted ileal resection. World J Gastroenterol 23:167–172

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kohga A, Yamashita K, Hasegawa Y, Yajima K, Okumura T, Isogaki J, Suzuki K, Kawabe A, Komiyama A (2017) Torsion of atypical Meckel’s diverticulum treated by laparoscopic-assisted surgery. Case Rep Med. https://doi.org/10.1155/2017/4514829

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wada Y, Ohtsuka H, Adachi K (2015) Laparoscopic views of obturator hernia. J Gastrointest Surg 19:1925–1926

    Article  PubMed  Google Scholar 

  18. Karashima R, Kimura M, Taura N, Shimokawa Y, Nishimura T, Baba H (2016) Total extraperitoneal approach for incarcerated obturator hernia repair. Hernia 20:479–482

    Article  CAS  PubMed  Google Scholar 

  19. Sasaki A, Takeuchi Y, Izumi K, Morimoto A, Inomata M, Kitano S (2016) Two-stage laparoscopic treatment for strangulated inguinal, femoral and obturator hernias: totally extraperitoneal repair followed by intestinal resection assisted by intraperitoneal laparoscopic exploration. Hernia 20:483–488

    Article  CAS  PubMed  Google Scholar 

  20. Köckerling F, Roessing C, Adolf D, Schug-Pass C, Jacob D (2016) Has endoscopic (TEP, TAPP) or open inguinal hernia repair a higher risk of bleeding in patients with coagulopathy or antithrombotic therapy? Data from the Herniamed Registry. Surg Endosc 30(5):2073–2081

    Article  PubMed  Google Scholar 

  21. Kohga A, Kawabe A, Cao Y, Yajima K, Okumura T, Yamashita K, Isogaki J, Suzuki K (2017) Elective laparoscopic repair after reduction might be useful strategy for incarcerated obturator hernia: a case report. J Surg Case Rep. https://doi.org/10.1093/jscr/rjx180

    Article  PubMed  PubMed Central  Google Scholar 

  22. Geffroy Y, Boulay-Coletta I, Jullès MC, Nakache S, Taourel P, Zins M (2014) Increased unenhanced bowel-wall attenuation at multidetector CT is highly specific of ischemia complicating small-bowel obstruction. Radiology 270:159–167

    Article  PubMed  Google Scholar 

  23. Millet I, Taourel P, Ruyer A, Molinari N (2015) Value of CT findings to predict surgical ischemia in small bowel obstruction: a systematic review and meta-analysis. Eur Radiol 25:1823–1835

    Article  PubMed  Google Scholar 

  24. Kohga A, Kawabe A, Yajima K, Okumura T, Yamashita K, Isogaki J, Suzuki K, Muramatsu K (2017) CT value of the intestine is useful predictor for differentiate irreversible ischaemic changes in strangulated ileus. Abdom Radiol (NY). https://doi.org/10.1007/s00261-017-1227-z

    Article  Google Scholar 

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Acknowledgements

This work was supported by departmental resources only.

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Authors and Affiliations

  1. Division of Surgery, Fujinomiya City General Hospital, 3-1, Nishiki-cho, Fujinomiya, Shizuoka, 4180076, Japan

    A. Kohga, A. Kawabe, T. Okumura, K. Yamashita, J. Isogaki & K. Suzuki

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  1. A. Kohga
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  2. A. Kawabe
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  3. T. Okumura
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  4. K. Yamashita
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  5. J. Isogaki
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  6. K. Suzuki
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Correspondence to A. Kohga.

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All authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with animals performed by any of the authors.

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Kohga, A., Kawabe, A., Okumura, T. et al. Laparoscopic repair is a treatment of choice for selected patients with incarcerated obturator hernia. Hernia 22, 887–895 (2018). https://doi.org/10.1007/s10029-018-1747-7

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  • DOI: https://doi.org/10.1007/s10029-018-1747-7

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