Emergent incarcerated groin hernias in adults: Presentations and clinical outcomes
Melih Akıncı, Kerim Bora Yılmaz, Zafer Ergül, Duray Şeker, Bahadır Külah, Hakan Kulaçoğlu
Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, 4. Genel Cerrahi Kliniği, Ankara, Türkiye
Abstract
Purpose: To identify the factors that affect the unfavorable clinic outcomes of emergent incarcerated groin hernias in adults.
Materials and Methods: Emergent repairs for incarcerated groin hernias were compared with elective repairs (n=109 versus 858) regarding age, gender, type of the hernia, recurrence, surgical repair, resections, type of the anesthesia, coexisting diseases, ASA scores, postoperative complications, duration of operation, duration of hospital stay and mortality. In order to analyze the factors associated with strangulation, omentum-bowel resection, postoperative local and systemic complications in emergent hernias, the gender, age, type of the hernia, recurrence rate, duration of symptoms, coexisting diseases, ASA scores and type of the anesthesia were analysed.
Results: When compared with elective hernia repairs, emergent hernias were found to be significantly associated with older age, female gender, omentum-bowel resection, higher ASA scores, coexisting diseases especially hypertension, longer duration of the operation, longer hospital stay, systemic postoperative complications and wound infections (p<0,05). In emergency admissions, recurrent hernia, coexisting diseases and high ASA scores were significant factors for strangulation, delayed admission was associated with omentalbowel resection, older age, recurrent hernias, high ASA scores were associated with systemic postoperative complications, advanced age, recurrent hernias, coexisting diseases and high ASA scores were associated with longer hospital stay (p<0,05).
Conclusion: Older age, recurrence, delayed admission, coexisting diseases and high ASA scores are unfavorable factors for emergent hernias. We think that it would be appropriate to give priority to these patient in elective hernia repairs. If the hernia is recurrent or the admission is delayed in emergent cases, surgeon should be careful regarding strangulation, resection and postoperative systemic complications.
Keywords: Groin hernia, strangulation, inguinal hernia