Department of General Surgery, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
Hernia. 2010 Oct;14(5):489-93. doi: 10.1007/s10029-010-0683-y. Epub 2010 Jun 5.
Hernia repairs are a common surgical procedure, and are associated with a significant cost. Despite the acceptance of the advantages of early elective hernia repairs, the incidence of emergency admissions with complicated presentations remains high, and the natural history of an untreated hernia is not obvious. This study aimed to define risk factors related with unfavorable outcomes in groin hernia repairs.
We analyzed the records of 685 elective or emergency repairs of groin hernias between December 2005 and June 2009. Patient age ranged from 17 to 85 years, with 240 (35%) of patients being older than 60 years of age. Indirect inguinal hernias were the most common hernia type in both sexes of patients. Coexisting cardiopulmonary problems were noted in 294 male and 33 female patients. American Society of Anaesthesiologists (ASA) grades 3 and 4 were encountered in 61 (9%) patients. Data were analyzed by chi-square test.
Significantly high incarceration and strangulation rates were found in females and femoral hernia type. The overall morbidity rate was 7%, major complications 3%. No mortality was observed in the series and postoperative complications were significantly more common in patients with high ASA score and severe coexisting cardiopulmonary problems. Advanced age, delayed admission, femoral type hernia and female sex were also linked with unfavorable outcomes.
The risk of complicated presentation and unfavorable outcome in patients with groin hernia is significant in the presence of factors such as advanced age, femoral hernia, female sex, delayed admission, severe coexisting cardiopulmonary problems and high ASA score. Although it is difficult to estimate the natural history of untreated hernia, hernia repairs of patients with the above-mentioned risk factors should be timely and elective.
疝修补术是一种常见的外科手术，费用高昂。尽管人们已经认识到早期择期疝修补术的优势，但伴有复杂表现的急诊入院率仍然很高，且未治疗疝的自然病程并不明显。本研究旨在确定与腹股沟疝修补术不良结局相关的危险因素。
我们分析了 2005 年 12 月至 2009 年 6 月期间 685 例择期或急诊腹股沟疝修补术的记录。患者年龄为 17 至 85 岁，240 例（35%）患者年龄大于 60 岁。男女患者中最常见的疝类型均为间接腹股沟疝。294 例男性和 33 例女性患者存在并存心肺问题。61 例（9%）患者的美国麻醉医师协会（ASA）分级为 3 级和 4 级。数据通过卡方检验进行分析。
女性和股疝类型的嵌顿和绞窄发生率明显较高。总体发病率为 7%，主要并发症为 3%。该系列研究中无死亡病例，ASA 评分高且并存严重心肺问题的患者术后并发症明显更为常见。高龄、延迟入院、股疝类型和女性也与不良结局相关。
在存在高龄、股疝、女性、延迟入院、严重并存心肺问题和高 ASA 评分等因素的情况下，腹股沟疝患者出现复杂表现和不良结局的风险显著增加。虽然难以估计未治疗疝的自然病程，但对于存在上述危险因素的患者，应及时进行择期疝修补术。
