Factors affecting morbidity and mortality in incarcerated abdominal wall hernias

Derıcı, Hayrullah; Ünalp, Haluk Recai; Bozdağ, Ali Doğan; Nazli, Okay; Tansuğ, Tuğrul; Kamer, Erdinç

doi:10.1007/s10029-007-0226-3

Cited by 78 publications

(73 citation statements)

References 15 publications

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“…The rates of mortality and morbidity have been reported to be approximately 5% and 20%-30%, respectively. [2,[4][5][6] The results obtained in the present study were consistent with the literature showing a mortality rate of 3.1% and a morbidity rate of 14.2%. Many factors affecting mortality and morbidity have been reported.…”

Section: Discussionsupporting

confidence: 92%

“…[4,7] Derici et al [5] reported that the type of anesthesia had no effect on mortality, but general anesthesia significantly increased the morbidity as compared to spinal anesthesia. The present study demonstrated that general anesthesia increased the morbidity as compared to spinal anesthesia (p=0.017), but had no significant effect on mortality (p=1.00).…”

Section: Discussionmentioning

confidence: 99%

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Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

Özkan¹,

Yıldız²,

Çakır³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada, acil cerrahi kliniğimizde boğulmuş abdominal duvar hernisi nedeniyle ameliyat edilen hastalarda morbidite ve mortaliteyle ilişkili risk faktörlerinin insidansı araştırıldı. GEREÇ VE YÖNTEMHastalar hem fıtık türüne göre (inguinal, umblikal, insizyonel, femoral) kendi aralarında hem de morbidite ve mortalite üzerine etkili faktörler bakımından; yaş, cinsiyet, Amerikan Anesteziyoloji Derneği (AAD) skoru, anestezi tipi, eşlik eden hastalıklar, intestinal boğulma ve nekroz varlığı gibi verilerle değerlendirildi. BULGULARİnguinal herni erkeklerde, umblikal ve femoral herni kadınlarda sıktı (p<0,001). Femoral hernide boğulma ve nekrozdan dolayı intestinal rezeksiyon diğer fıtık türleri-ne göre anlamlı olarak yüksek saptandı (sırasıyla, p<0,005 ve p<0,001). Morbidite ve mortalite üzerine; ileri yaş (≥65 yaş), ek hastalık, strangülasyon, nekroz, yüksek AAD skoru (III, IV), semptomların başlama ve hastaneye başvuru süresinin anlamlı etkisi bulundu. Genel anestezinin de morbidite için risk oluşturduğu görüldü (p<0,05). SONUÇBoğulmuş abdominal duvar hernileri yüksek morbidite ve mortalite oranına sahip bir cerrahi problemdir. Bu yüzden herni saptandığında elektif koşullarda ameliyat planlanmalıdır.Anahtar Sözcükler: Abdominal duvar hernisi; inkarserasyon; nekroz; strangülasyon. BACKGROUNDThe aim of the present study was to investigate morbidityand mortality-related risk factors in patients undergoing surgery due to incarcerated abdominal wall hernia. METHODSThe patients were grouped according to the type of hernia (inguinal, umbilical, incisional, femoral), and these groups were evaluated in terms of risk factors affecting morbidity and mortality such as age, gender, American Society of Anesthesiologists (ASA) score, type of anesthesia, concomitant diseases, and the presences of intestinal strangulation and necrosis. RESULTSInguinal hernia was frequent in males, whereas femoral hernia was frequent in females (p<0.001). The rate of intestinal resection due to strangulation and necrosis was found significantly higher among femoral hernias as compared to the other types of hernia (p<0.005 and p<0.001, respectively). Advanced age (≥65 years), concomitant disease, strangulation, necrosis, high ASA score (III-IV), time from the onset of symptoms, and time to hospital admission were found to have significant influences on morbidity and mortality. General anesthesia was found to be a risk factor for morbidity as well (p<0.05). CONCLUSIONIncarcerated abdominal wall hernias are surgical problems with high morbidity and mortality rates. Therefore, surgery should be planned under elective conditions when hernia is detected.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

Özkan¹,

Yıldız²,

Çakır³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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“…Significant relationships have been noted between ASA risk scores and postoperative clinical outcomes, morbidity, and mortality. 7,8 The low complication rates in our study group, comprised of ASA I and II patients, and ASA III patients (with controlled disease) aged 18-79 years, together with the findings of past research, suggest that inguinal hernia surgery under local anesthesia is both economical and more reliable than other approaches, protecting patients from complications associated with other types of anesthesia. Recent research has shown that same-day surgery for patients undergoing inguinal hernia repair under local anesthesia is reliable, and applicable to patients of various ages differing in terms of surgical risk, who were not included in our group.…”

Section: Discussionsupporting

confidence: 61%

Is Same-Day Inguinal Hernia Surgery Possible?

Çapoğlu

Tiryaki

Karğı

et al. 2016

International Surgery

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The Lichtenstein hernia repair is associated with low recurrence rates and short operation times, and can be performed under local anesthesia. Thus, this is among the mostpreferred methods used in recent years. Our objective was to explore the same-day discharge rates, and the causes of delayed discharge and re-admission to hospital, of patients treated using the Lichtenstein repair method, to evaluate the feasibility of performing same-day hernia surgery in clinical practice. One hundred of a total of 236 patients diagnosed with unilateral inguinal or femoral hernias, who required surgical treatment, and who agreed with the conditions of the study, were prospectively included. All patients were treated using the Lichtenstein mesh repair method, under local anesthesia between June 2006 and January 2008. We investigated the types and locations of hernias, duration of surgery, seniority of the surgeon, the feasibility of same-day surgery in subgroups stratified by ASA risk scores, and postoperative complication rates, in patients who underwent inguinal surgery under local anesthesia. The rates of pain and postoperative complications were very low in hernia patients who underwent same-day surgery under local anesthesia. The operation reduces the length of hospital stay and helps patients mobilize earlier. Both the literature, and our data, indicate that inguinal hernia repair under local anesthesia is safe and effective, reducing anesthesia-related complications and the length of hospital stay; is cost-effective; and is applicable in all patients.

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“…İnkarsere hernilerde acil cerrahiyi takiben morbidite riski anestezi, antisepsi, antibiyoterapi ve sıvı tedavisindeki gelişmelere rağmen halen yüksektir. [1,2] İnkarsere karın duvarı fı-tıklarının tedavisinde amaç, düşük mortalite ve morbidite ile uzun süreli takiplerde düşük nüks oranlarıyla fıtık tamiri yapmaktır.…”

Section: Resultsunclassified

Factors affecting morbidity in urgent repair of abdominal wall hernia with intestinal incarceration in adults

Ezer¹,

Çalışkan²,

Çolakoğlu³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmanın amacı erişkin hastalarda oluşan intestinal inkarserasyonlu karın duvarı fıtıklarında morbiditeyi etkileyen faktörleri araştırmaktır. GEREÇ VE YÖNTEMMart 1999-Mart 2008 tarihleri arasında 124 olgu (73 erkek) inkarsere intestinal fıtık tanısı ile acil ameliyat edildi. Olguların yaş ortalaması 61±13,87 idi. Ortanca fıtık süresi 5 yıl (0,1-30) bulundu. Fıtık tipi, fıtık süresi, yandaş hastalıklar, uygulanan cerrahi tedavi ve ameliyat sonrası komplikasyon bilgileri geriye dönük araştırıldı. BULGULARYirmi beş hastada (%20) komplikasyon gelişti. On iki hastada (%10) cerrahi alan enfeksiyonu, 10 hastada (%8) septik komplikasyonlar oluştu. Dört hasta (%3) ameliyat sonrası dönemde kaybedildi. Strangülasyon gelişmiş 40 olgunun 18'ine bağırsak rezeksiyonu yapıldı. Bağırsak rezeksiyonu yapılmasıyla ilişkili tek bağımsız değişkenin kasık fıtığı dışındaki fıtıklar olduğu görüldü (p=0,039). Fı-tık süresi ve inkarserasyon süresi ile komplikasyonlar arasında anlamlı bir ilişki saptanmadı. Yandaş hastalığı olanlarda komplikasyon oranları anlamlı derecede yüksek idi (p<0,001). Yaş ile komplikasyon gelişimi arasında da anlamlı ilişki bulundu (p=0,034). Çok değişkenli analizde komplikasyon oluşumunda tek bağımsız değişkenin ASA skoru olduğu saptandı (p<0,001). SONUÇYandaş hastalığı olan ve ASA skoru yüksek hastalarda komplikasyon oranı yüksek olduğundan fıtık boğulması gelişmeden önce planlı ameliyat yapılması önerilir.

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Factors affecting morbidity and mortality in incarcerated abdominal wall hernias

Abstract: 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.

Cited by 78 publications

References 15 publications

Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

Is Same-Day Inguinal Hernia Surgery Possible?

Factors affecting morbidity in urgent repair of abdominal wall hernia with intestinal incarceration in adults

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