急诊剖腹探查术治疗嵌顿性闭孔疝的疗效

Efficacy of emergency exploratory laparotomy in incarcerated obturator hernia.

作者信息

Wu Tian-Chong, Lu Qiao, Liang Xiao-Hui

机构信息

a Department of Hepatobiliary and Pancreatic Surgery , The Second Medical College, Shenzhen People's Hospital, Jinan University , Shenzhen , Guangdong Province , China.

b Department of Gastrointestinal Surgery , Huizhou Municipal Central Hospital, Affiliated Huizhou Hospital of Sun Yat-sun University , Huizhou , Guangdong Province , China.

出版信息

Acta Chir Belg. 2018 Apr;118(2):105-109. doi: 10.1080/00015458.2017.1394671. Epub 2017 Oct 25.

DOI:10.1080/00015458.2017.1394671

PMID:29065783

Abstract

BACKGROUND

Incarcerated obturator hernia (IOH) is a scarce type of acute surgical disease, but the mortality rate is the highest in abdominal hernias. The aim of this study was to evaluate the efficacy of emergency exploratory laparotomy (EEL) in treating incarcerated obturator hernia (IOH).

METHODS

We conducted a retrospective study of 12 female patients with IOH underwent EEL between January 2014 and March 2016. The variables which included patient characteristics, findings of CT, operative time, postoperative complications, length of hospital stay, ICU admission rate, 30-day readmission rate and mortality were analyzed.

RESULTS

The age of patients was 82.5 ± 4.2 years and the median body mass index (BMI) was 20.6 kg/m (IQR, 18.7-21.5 kg/m). There were 10 patients (83.3%) underwent partial intestinal resection due to partial small bowel necrosis or perforation. The total operation time was 85.7 ± 8.7 min. The time to initiation of a soft diet was 3.9 ± 0.7 days and the median length of stay was 15.0 days (IQR, 14.0-17.5 days), respectively.

CONCLUSIONS

The EEL is a clinically safe and necessary choice for early diagnosis and treatment in IOH. EEL may improve the curative effect of IOH significantly.

摘要

背景

闭孔嵌顿疝（IOH）是一种罕见的急性外科疾病，但在腹外疝中死亡率最高。本研究的目的是评估急诊剖腹探查术（EEL）治疗闭孔嵌顿疝（IOH）的疗效。

方法

我们对2014年1月至2016年3月期间接受EEL治疗的12例女性IOH患者进行了回顾性研究。分析了包括患者特征、CT检查结果、手术时间、术后并发症、住院时间、入住重症监护病房率、30天再入院率和死亡率等变量。

结果

患者年龄为82.5±4.2岁，中位体重指数（BMI）为20.6kg/m（四分位间距，18.7-21.5kg/m）。10例患者（83.3%）因部分小肠坏死或穿孔接受了部分肠切除术。总手术时间为85.7±8.7分钟。开始进食软食的时间为3.9±0.7天，中位住院时间分别为15.0天（四分位间距，14.0-17.5天）。