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Outcomes of emergency and elective femoral hernia surgery in four district general hospitals: a 4-year study

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Abstract

Introduction

A large number of femoral herniae present as emergencies accounting for significant morbidity and mortality, which have remained unchanged over the last decade. Reports of outcomes in femoral hernia surgery are scarce, even more so in district general hospitals where a significant proportion of surgeries are performed. This study compares results of emergency and elective femoral hernia surgery in four district general hospitals against published rates up to a decade ago.

Materials and methods

A retrospective study of all patients undergoing femoral hernia surgery in four district hospitals between 2000 and 2004.

Results

Seventy-three patients had 75 (28 emergency, 47 elective) femoral hernia repairs. Emergency presentations were associated with increased age(P = 0.001) and right-sided hernias (P = 0.024). Emergency surgery led to increased bowel resection (10.7 vs. 0%, P < 0.001) and longer hospital stays (8 vs. 1 day, P < 0.001) compared to elective surgery. There was no difference in complication rates between emergency and elective surgery (21.4 vs. 12.8%, P = 0.322) or opposition and pectineal flap repair (12.9 vs. 36.4%, P = 0.149). Overall recurrence, morbidity, and mortality were 4.2, 16 and 1.3%, respectively. One patient (3.6%) died after emergency surgery, and no deaths occurred with elective surgery.

Conclusion

The proportion of femoral herniae presenting as emergencies remained unchanged. This accounts for the morbidity and mortality in femoral surgery, which remains high and similar to a decade ago. Early diagnosis by clinicians and general practitioners and elective surgery are required to reduce mortality. Further investigation into the effect of the opposition technique on femoral vein compression and deep venous thrombosis is warranted.

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References

  1. Devlin B (1982) Hernia. In: Russell RCG (ed) Recent advances in surgery II. Churchill Livingstone, London, pp 209–223

    Google Scholar 

  2. Quill DS, Devlin HB, Plant JA, Denham KR, McNay RA, Morris D (1983) Surgical operation rates: a 12 year experience in Stockton-on-Tees. Ann R Coll Surg Engl 65:248–253

    PubMed  CAS  Google Scholar 

  3. Malek S, Torella F, Edwards PR (2004) Emergency repair of groin herniae: outcome and implications for elective surgery waiting times. Int J Clin Pract 58:207–209

    Article  PubMed  CAS  Google Scholar 

  4. Kemler MA, Oostvogel HJ (1997) Femoral hernia: is a conservative policy justified? Eur J Surg 163:187–190

    PubMed  CAS  Google Scholar 

  5. Brittenden J, Heys SD, Eremin O (1991) Femoral hernia: mortality and morbidity following elective and emergency surgery. J R Coll Surg Edinb 36:86–88

    PubMed  CAS  Google Scholar 

  6. Sanchez-Bustos F, Ramia JM, Fernandez Ferrero F (1998) Prosthetic repair of femoral hernia: audit of long-term follow-up. Eur J Surg 164:191–193

    Article  PubMed  CAS  Google Scholar 

  7. GiJes GR (1992) The abdominal wall and hernias. In: Cuschieri A (ed) Essential surgical practice. Butterworth Heinemann, Oxford, pp 1265

    Google Scholar 

  8. Bendavid R (1987) A femoral “umbrella” for femoral hernia repair. Surg Gynecol Obstet 165(2):153–156

    PubMed  CAS  Google Scholar 

  9. Lichtenstein IL, Shore JM (1974) Simplified repair of femoral and recurrent inguinal hernias by a “plug” technic. Am J Surg 128:439–444

    Article  PubMed  CAS  Google Scholar 

  10. Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G, Sahin M (2006) Femoral hernia: a review of 83 cases. Hernia 10:70–73

    Article  PubMed  CAS  Google Scholar 

  11. Swarnkar K, Hopper N, Nelson M, Feroz A, Stephenson BM (2003) Outcomes of patients with severe chronic groin pain following repair of groin hernia. Br J Surg 90:367–368

    Article  PubMed  CAS  Google Scholar 

  12. Kulah B, Duzgun AP, Moran M, Kulacoglu IH, Ozmen MM, Coskun F (2001) Emergency hernia repairs in the elderly. Am J Surg 182:455–459

    Article  PubMed  CAS  Google Scholar 

  13. Gallegos NC, Dawson J, Jarvis M, Hobsley M (1991) Risk of strangulation in groin hernias. Br J Surg 78:1171–1173

    Article  PubMed  CAS  Google Scholar 

  14. Licheri S, Edras E, Pomata M, Pisano G, Daniele GM (2004) Femoral hernia repair with Bard Mesh Dart Plug. Chir Ital 56(5):705–710

    PubMed  Google Scholar 

  15. McGugan E, Burton H, Nixon SJ, Thompson AM (2000) Death following hernia surgery: room for improvement. J R Coll Surg Edinb 45:183–186

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Scarborough General Hospital, Woodlands Drive, Scarborough, Yorkshire, YO12 6QL, UK

    A. Suppiah, M. Gatt, J. Barandiaran, M. S. Heng & E. P. Perry

  2. Academic Surgical Unit, Castle Hill Hospital, Castle Road, Cottingham, HU16 5JQ, UK

    A. Suppiah

Authors
  1. A. Suppiah
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  2. M. Gatt
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  3. J. Barandiaran
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  4. M. S. Heng
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  5. E. P. Perry
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Corresponding author

Correspondence to A. Suppiah.

Additional information

All authors have seen and approved the manuscript and are fully conversant with its contents.

This manuscript is not under consideration for publication nor has it been published elsewhere. The data set has not been published nor is under consideration for publication elsewhere. The data were presented at the The Royal College of Surgeons of Edinburgh Quincentenary Conference, July 2005 in poster form.

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Suppiah, A., Gatt, M., Barandiaran, J. et al. Outcomes of emergency and elective femoral hernia surgery in four district general hospitals: a 4-year study. Hernia 11, 509–512 (2007). https://doi.org/10.1007/s10029-007-0262-z

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  • DOI: https://doi.org/10.1007/s10029-007-0262-z

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