Department of Surgery, Cantonal Hospital of Baden, Im Ergel 1, 5404, Baden, Switzerland.
Langenbecks Arch Surg. 2022 Dec;407(8):3711-3717. doi: 10.1007/s00423-022-02650-1. Epub 2022 Aug 17.
Incarcerated inguinal hernias can promote bowel ischemia. Emergent bowel resection is associated with increased postoperative morbidity. Risk factors for bowel resection might identify patients who benefit from elective inguinal hernia repair.
Sixty-five consecutive patients undergoing emergency inguinal hernia repair between 2012 and 2018 at our institution were entered in a prospective database. Data analysis was approved by the local ethics committee. Patient characteristics, surgery data, and postoperative outcomes were compared between patients with and without bowel resection. Risk factors for bowel resection were assessed with univariate and multivariate analysis.
Patients requiring bowel resection were more often female (87%, P = 0.004) and presented in 67% with a femoral hernia. Postoperative complications occurred more often after hernia reduction and bowel resection compared to no resection (67% vs. 36%, P = 0.035). ASA score 3-4 and femoral herniation were independent predictors of bowel resection (P = 0,046 and P = 0,047, respectively).
Highly comorbid patients can profit from early elective hernia repair to prevent bowel resection.
嵌顿性腹股沟疝可导致肠缺血。紧急肠切除术与术后高发病率相关。肠切除术的风险因素可能可以识别出从择期腹股沟疝修补术中获益的患者。
2012 年至 2018 年期间，我院对 65 例连续接受紧急腹股沟疝修补术的患者进行了前瞻性数据库登记。数据分析得到了当地伦理委员会的批准。对比有和无肠切除术患者的患者特征、手术数据和术后结局。使用单因素和多因素分析评估肠切除术的风险因素。
需要进行肠切除术的患者更常为女性（87%，P=0.004），且 67%的患者为股疝。与未行肠切除的患者相比，疝复位和肠切除术后的术后并发症更常见（67% vs. 36%，P=0.035）。ASA 评分 3-4 级和股疝是肠切除术的独立预测因素（P=0.046 和 P=0.047）。
合并症高的患者可从早期择期疝修补术中获益，以预防肠切除术。
