Center for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospitals, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, DK, Denmark.
Emergency Department, Nykøbing Falster Hospital, Ejergodvej 63, 4800, Nykøbing Falster, Denmark.
Hernia. 2023 Dec;27(6):1451-1459. doi: 10.1007/s10029-023-02891-z. Epub 2023 Sep 25.
We aimed describe the patient characteristics, surgical details, postoperative outcomes, and prevalence and incidence of obturator hernias. Obturator hernias are rare with high mortality and no consensus on the best surgical approach. Given their rarity, substantial data is lacking, especially related to postoperative outcomes.
The study was based on data from the nationwide Danish Hernia Database. All adults who underwent obturator hernia surgery in Denmark during 1998-2023 were included. The primary outcomes were demographic characteristics, surgical details, postoperative outcomes, and the prevalence and incidence of obturator hernias.
We included 184 obturator hernias in 167 patients (88% females) with a median age of 77 years. Emergency surgeries constituted 42% of repairs, and 72% were laparoscopic. Mesh was used in 77% of the repairs, with sutures exclusively used in emergency repairs. Concurrent groin hernias were found in 57% of cases. Emergency surgeries had a 30-day mortality of 14%, readmission rate of 21%, and median length of stay of 6 days. Elective surgeries had a 30-day mortality of 0%, readmission rate of 10%, and median length of stay of 0 days. The prevalence of obturator hernias in hernia surgery was 0.084% (95% CI: 0.071%-0.098%), with an incidence of one per 400,000 inhabitants annually.
This was the largest cohort study to date on obturator hernias. They were rare, affected primarily elderly women. The method of repair depends on whether the presentation is acute, and emergency repair is associated with higher mortality.
我们旨在描述患者特征、手术细节、术后结果以及闭孔疝的患病率和发病率。闭孔疝罕见，死亡率高，对于最佳手术方法尚无共识。鉴于其罕见性，缺乏大量数据，特别是与术后结果相关的数据。
该研究基于丹麦全国疝数据库的数据。所有在丹麦接受闭孔疝手术的成年人都包括在内，研究时间为 1998 年至 2023 年。主要结局是人口统计学特征、手术细节、术后结果以及闭孔疝的患病率和发病率。
我们纳入了 167 名患者（88%为女性）的 184 例闭孔疝，中位年龄为 77 岁。急诊手术占修复手术的 42%，72%为腹腔镜手术。77%的修复手术使用了网片，仅在急诊修复手术中使用了缝线。57%的病例同时存在腹股沟疝。急诊手术 30 天死亡率为 14%，再入院率为 21%，中位住院时间为 6 天。择期手术 30 天死亡率为 0%，再入院率为 10%，中位住院时间为 0 天。在疝手术中，闭孔疝的患病率为 0.084%（95%CI：0.071%-0.098%），发病率为每年每 40 万人中有一例。
这是迄今为止关于闭孔疝的最大队列研究。它们罕见，主要影响老年女性。修复方法取决于发病的急缓，急诊修复与更高的死亡率相关。
