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嵌顿性腹股沟疝患者肠道切除的风险与结局:回顾性研究

Risk and outcome of bowel resection in patients with incarcerated groin hernias: retrospective study.

作者信息

Kurt Necmi, Oncel Mustafa, Ozkan Zeynep, Bingul Sadik

机构信息

General Surgery Department, Kartal Education and Research Hospital, Istanbul, Turkey.

出版信息

World J Surg. 2003 Jun;27(6):741-3. doi: 10.1007/s00268-003-6826-x. Epub 2003 May 2.

Abstract

The goal of this retrospective study was to evaluate factors that increase the risk of bowel necrosis and document the outcome of bowel resection in patients with strangulated hernias. We identified 102 patients (60 men, 42 women) who underwent surgical treatment for an incarcerated hernia at the Kartal Education and Research Hospital Emergency Unit between April 1997 and April 2001. Patients in group 1 required intestinal resection (n = 16), and patients in group 2 did not (n = 86). The median age of the patients was 53 years (range 3-96). Demographic and surgical data were obtained from the patients' charts and compared between the two groups. Women required bowel resections more often than men (p < 0.05). Patients older than 65 years and those with femoral or epigastric hernias required resection more often than patients younger than 65 years and those with inguinal, umbilical, or incisional hernias (p < 0.05 for all). Group 1 patients had a longer hospitalization and experienced more overall complications and wound infections than group 2 (p < 0.05 for all). In conclusion, incarcerated hernias are more common in men, but intestinal resection is required more often in women. The risk of intestinal resection is higher for patients with femoral hernias and those older than 65 years. Patients who undergo intestinal resection have a higher overall complication rate related to wound infections but not an increased risk of other complications or mortality.

摘要

这项回顾性研究的目的是评估增加肠坏死风险的因素,并记录绞窄性疝患者肠切除的结果。我们确定了102例患者(60例男性,42例女性),他们于1997年4月至2001年4月在卡尔塔尔教育与研究医院急诊科接受了嵌顿疝的手术治疗。第1组患者需要进行肠切除(n = 16),第2组患者则不需要(n = 86)。患者的中位年龄为53岁(范围3 - 96岁)。从患者病历中获取人口统计学和手术数据,并在两组之间进行比较。女性比男性更常需要进行肠切除(p < 0.05)。65岁以上的患者以及患有股疝或上腹疝的患者比65岁以下的患者以及患有腹股沟疝、脐疝或切口疝的患者更常需要进行切除(所有p < 0.05)。第1组患者的住院时间更长,总体并发症和伤口感染比第2组更多(所有p < 0.05)。总之,嵌顿疝在男性中更常见,但女性更常需要进行肠切除。股疝患者和65岁以上患者进行肠切除的风险更高。接受肠切除的患者与伤口感染相关的总体并发症发生率更高,但其他并发症或死亡率的风险并未增加。

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