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Factors affecting morbidity and mortality in incarcerated abdominal wall hernias

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Abstract

Background

Incarcerated abdominal wall hernia cases may necessitate emergency interventions, but under such circumstances morbidity and mortality rates may increase. The aim of this study was to investigate the factors that affect morbidity and mortality in patients with incarcerated abdominal wall hernias who underwent emergency surgery.

Methods

Urgent surgical interventions due to incarcerated abdominal wall hernias were performed in 182 patients in our clinics between January 1998 and January 2006. Factors that affect morbidity and mortality in incarcerated abdominal wall hernias were investigated retrospectively by browsing the archives. Logistic regression analysis was used to evaluate parameters that affect morbidity and mortality.

Results

Morbidity and mortality occurred in 43 (23.6%) and 9 (4.9%) patients, respectively. A symptomatic period of longer than 8 h, presence of accompanying disease, high American Society of Anesthesiology (ASA) score, general anesthesia, presence of strangulation, and necrosis were found to affect morbidity significantly by univariate analysis. Necrosis was the sole factor affecting morbidity significantly by multivariate analysis. Advanced age, presence of accompanying disease, high ASA score, presence of strangulation, necrosis, and hernia repair with graft were found to affect mortality significantly by univariate analysis; however, necrosis was the sole factor affecting mortality significantly by multivariate analysis.

Conclusions

Intestinal necrosis, which was followed by bowel resection, was the sole factor affecting morbidity and mortality using multivariate logistic regression analysis. Emergency surgery is required for incarcerated abdominal wall hernias before intestinal necrosis develops.

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References

  1. Andrews NJ (1981) Presentation and outcome of strangulated external hernia in a district general hospital. Br J Surg 68:329–332

    Article  PubMed  CAS  Google Scholar 

  2. Kulah B, Kulacoglu IH, Oruc MT, Duzgun AP, Moran M, Ozmen MM, Coskun F (2001a) Presentation and outcome of incarcerated external hernias in adults. Am J Surg 181:101–104

    Article  PubMed  CAS  Google Scholar 

  3. Oishi SN, Page CP, Schwesinger WH (1991) Complicated presentations of groin hernias. Am J Surg 162:568–571

    Article  PubMed  CAS  Google Scholar 

  4. Kurt N, Oncel M, Ozkan Z, Bingul S (2003) Risk and outcome of bowel resection in patients with incarcerated groin hernias: retrospective study. World J Surg 27:741–743

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  6. Rosenthal RA, Zenilman ME (2001) Surgery in the elderly. In: Townsend CM, Beauchamp RD, Evers MB, Mattox KL (eds) The biological basis of modern surgical practice, 16th ed. WB Saunders, Philadelphia, pp 226–246

    Google Scholar 

  7. Dunne JR, Malone DL, Tracy JK, Napolitano LM (2003) Abdominal wall hernias: risk factors for infection and resource utilization. J Surg Res 111:78–84

    Article  PubMed  Google Scholar 

  8. Nesterenko IuA, Shovskii OL (1993) Outcome of treatment of incarcerated hernia. Khirurgiia (Mosk) 9:26–30

    Google Scholar 

  9. Heydorn WH, Velanovich V (1990) A 5-year US Army experience with 36,250 abdominal hernia repairs. Am Surg 56:596–600

    PubMed  CAS  Google Scholar 

  10. Alvarez JA, Baldonedo RF, Bear IG, Solis JAS, Alvarez P, Jorge JI (2004) Incarcerated groin hernias in adults: presentation and outcome. Hernia 8:121–126

    Article  PubMed  CAS  Google Scholar 

  11. Pollak R, Nyhus LM (1989) Strangulating external hernia. In: Nyhus LM, Condon RE (eds) Hernia, 3rd edn. JB Lipponcott, Philadelphia, pp 273–283

    Google Scholar 

  12. Golub R, Cantu R (1998) Incarcerated anterior abdominal wall hernias in a community hospital. Hernia 2:157–161

    Article  Google Scholar 

  13. Rai S, Chandra SS, Smile SR (1998) A study of the risk of strangulation and obstruction in groin hernias. ANZ Surg 68:650–654

    CAS  Google Scholar 

  14. Haapaniemi S, Sandblom G, Nilsson E (1999) Mortality after elective and emergency surgery for inguinal and femoral hernia. Hernia 4:205–208

    Article  Google Scholar 

  15. Hetzer FH, Hotz T, Steinke W, Schlumpf R, Decurtins M, Largiader F (1999) Gold standard for inguinal hernia repair: Shouldice or Lichtenstein? Hernia 3:117–120

    Article  Google Scholar 

  16. Nilsson E, Haapaniemi S, Gruber G, Sandblom G (1998) Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996. Br J Surg 85:1686–1691

    Article  PubMed  CAS  Google Scholar 

  17. Gilbert AI, Graham MF, Voigt WJ (1999) A bilayer patch device for inguinal hernia repair. Hernia 3:161–166

    Article  Google Scholar 

  18. Wysocki A, Pozniczek M, Krzywon J, Bolt L (2001) Use of polypropylene prostheses for strangulated inguinal and incisional hernias. Hernia 5:105–106

    Article  PubMed  CAS  Google Scholar 

  19. Papaziogas B, Lazaridis Ch, Makris J, Koutelidakis J, Patsas A, Grigoriou M, Chatzimavroudis G, Psaralexis K, Atmatzidis K (2005) Tension-free repair versus modified Bassini technique (Andrews technique) for strangulated inguinal hernia: a comparative study. Hernia 9:156–159

    Article  PubMed  CAS  Google Scholar 

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Derici, H., Unalp, H.R., Bozdag, A.D. et al. Factors affecting morbidity and mortality in incarcerated abdominal wall hernias. Hernia 11, 341–346 (2007). https://doi.org/10.1007/s10029-007-0226-3

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  • DOI: https://doi.org/10.1007/s10029-007-0226-3

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