Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, Sichuan, China.
BMC Surg. 2021 Mar 9;21(1):124. doi: 10.1186/s12893-021-01125-2.
To explore the clinical characteristics, diagnosis and treatment of obturator hernia.
Eighty-six patients who were diagnosed as obturator hernia by abdominal CT in the Department of Gastrointestinal Surgery of our hospital between 2009 and 2019 were enrolled in this study. Patient characteristics, surgical method, postoperative complications and mortalities were retrospectively reviewed.
Thirty days mortality rate of 5.5% and 46.1% were observed in surgery group and non-surgery group, respectively. Surgery was performed as an emergency procedure in 59 cases and elective procedure in 14 cases depending on different hernia contents, intestinal necrosis and signs of peritonitis. In the emergency surgery group, segmental intestinal resection with anastomosis was performed in 24 patients (24/59, 40.7%). There were 4 deaths (4/59, 6.8%) in this group, all of which occurred in patients undergoing SI resections. In contrast, no bowel resection, postoperative complications, or death occurred in the elective surgery group. 3-year recurrence rates of 5.1% (3/59) and 7.1% (1/14) were observed in the emergency surgery and the elective surgery group, respectively.
CT examination plays an important role in improving the diagnostic rate of obturator hernia. Timely surgical treatment is the key to improve the efficacy of obturator hernia and prevent the deterioration of the condition. In addition, intestinal resection and postoperative complications may be the important factors leading to postoperative death.
探讨闭孔疝的临床特点、诊断及治疗方法。
回顾性分析 2009 年至 2019 年我院胃肠外科经腹部 CT 诊断为闭孔疝的 86 例患者的临床资料。分析患者的一般资料、手术方法、术后并发症及病死率。
手术组和非手术组的 30 天病死率分别为 5.5%和 46.1%。根据疝内容物、肠坏死及腹膜炎表现,59 例患者中急症手术 59 例,择期手术 14 例。急症手术中,行肠段切除吻合术 24 例(24/59,40.7%),其中 4 例(4/59,6.8%)死亡,均为行乙状结肠切除术患者。择期手术患者无肠切除,无术后并发症及死亡。急症手术组和择期手术组的 3 年复发率分别为 5.1%(3/59)和 7.1%(1/14)。
CT 检查对提高闭孔疝的诊断率有重要作用。及时的外科治疗是提高闭孔疝疗效、防止病情恶化的关键。此外,肠切除和术后并发症可能是导致术后死亡的重要因素。