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- Title
Optimal timeline for emergency surgery in patients with strangulated groin hernias.
- Authors
Koizumi, M.; Sata, N.; Kaneda, Y.; Endo, K.; Sasanuma, H.; Sakuma, Y.; Ota, M.; Lefor, A.; Yasuda, Y.
- Abstract
Purpose: This retrospective study evaluates the clinical course and outcomes of patients who underwent surgery for strangulated hernias. Methods: Among 520 groin hernias from 2001 to 2012, 51 inguinal and 42 femoral hernias were strangulated and operated emergently at a tertiary referral center. Perioperative factors, patient profiles, and time interval to surgery ( T = time from onset to surgery, T = time from onset to initial evaluation, T = time from the first hospital to the tertiary center, T = time from admission at the tertiary center to surgery, T = T + T + T) were analyzed in patients with strangulation, then compared between two groups, the bowel resection (BR) group and the non-bowel resection (NBR) group. Results: T, T and T in the bowel resection group were significantly longer than those in the non-bowel resection group ( P < 0.05). Patients who presented initially to the tertiary center ( T = 0) had a significantly lower resection rate than patients transported from other hospitals (24 vs. 44 %, P = 0.048). There was no significant difference in morbidity between the BR and NBR groups (35 vs. 24 %, P = 0.231). Conclusions: The elapsed time from onset to surgery, especially T and T, is the most important prognostic factor in patients with strangulated groin hernias. Early diagnosis and transportation are essential for good outcomes.
- Subjects
INGUINAL hernia; FEMORAL hernia; POSTOPERATIVE care; GROIN; INPATIENT care
- Publication
Hernia, 2014, Vol 18, Issue 6, p845
- ISSN
1265-4906
- Publication type
Article
- DOI
10.1007/s10029-014-1219-7