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Risk of bowel resection in incarcerated inguinal hernia: watch out for ASA score and hernia type

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Abstract

Purpose

Incarcerated inguinal hernias can promote bowel ischemia. Emergent bowel resection is associated with increased postoperative morbidity. Risk factors for bowel resection might identify patients who benefit from elective inguinal hernia repair.

Methods

Sixty-five consecutive patients undergoing emergency inguinal hernia repair between 2012 and 2018 at our institution were entered in a prospective database. Data analysis was approved by the local ethics committee. Patient characteristics, surgery data, and postoperative outcomes were compared between patients with and without bowel resection. Risk factors for bowel resection were assessed with univariate and multivariate analysis.

Results

Patients requiring bowel resection were more often female (87%, P = 0.004) and presented in 67% with a femoral hernia. Postoperative complications occurred more often after hernia reduction and bowel resection compared to no resection (67% vs. 36%, P = 0.035). ASA score 3–4 and femoral herniation were independent predictors of bowel resection (P = 0,046 and P = 0,047, respectively).

Conclusion

Highly comorbid patients can profit from early elective hernia repair to prevent bowel resection.

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Data availability

Herniamed Registry.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Surgery, Cantonal Hospital of Baden, Im Ergel 1, 5404, Baden, Switzerland

    Anja Katharina Dwertmann, Sebastian Soppe, Lukas Hefermehl, Andreas Keerl, Andrea Wirsching & Antonio Nocito

Authors
  1. Anja Katharina Dwertmann
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  2. Sebastian Soppe
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  3. Lukas Hefermehl
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  4. Andreas Keerl
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  5. Andrea Wirsching
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  6. Antonio Nocito
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Anja Katharina Dwertmann, Andrea Wirsching and Sebastian Soppe. The first draft of the manuscript was written by Anja Katharina Dwertmann and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Antonio Nocito.

Ethics declarations

Ethics approval

The local ethics committee approved the current study (Project-ID 2021–01291, Ethikkommission Nordwest- und Zentralschweiz).

Consent to participate

Patients provided written informed consent for documentation of their anonymized patient data in the Herniamed Registry GmbH i.G.

Consent for publication

All authors reviewed the final version of the manuscript and approved its submission.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Andrea Wirsching and Antonio Nocito shared the last authorship.

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Dwertmann, A.K., Soppe, S., Hefermehl, L. et al. Risk of bowel resection in incarcerated inguinal hernia: watch out for ASA score and hernia type. Langenbecks Arch Surg 407, 3711–3717 (2022). https://doi.org/10.1007/s00423-022-02650-1

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  • DOI: https://doi.org/10.1007/s00423-022-02650-1

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