Prognostic factors of postoperative morbidity and mortality in strangulated groin hernia.
Fiche publication
Date publication
août 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MEYER Nicolas, Pr ROHR Serge, Dr ROMAIN Benoit, Pr BRIGAND Cécile
Tous les auteurs :
Romain B, Chemaly R, Meyer N, Brigand C, Steinmetz JP, Rohr S
Lien Pubmed
Résumé
OBJECTIVE: Strangulated groin hernia is a serious surgical emergency, as it is associated with high morbidity and mortality (2.6-9 %). This retrospective study aimed to find significant prognostic factors of postoperative morbidity and mortality. METHODS: From January 2000 to August 2011, we analyzed all patients who had undergone surgery in emergency for strangulated groin hernia. Forty-nine patients out of 2,917 were operated on strangulated groin hernia in an emergency. RESULTS: The occurrence of strangulated hernia during this period was 1.7 %. Thirty patients out of 49 had inguinal (61.2 %) and 19 femoral (38.8 %) strangulated hernias. The median age was 68.9 years +/- 15.3. Patients with strangulated femoral hernia were significantly older than those with inguinal hernia (P = 0.03). There was a significant predominance of men in the inguinal hernia group and a female predominance in the femoral hernia group (P = 0.001). An additional exploration was performed on 12 patients (24.5 %). This exploration was done through a midline laparotomy in 8 patients, a laparoscopy in a single patient and the hernioscopy technique was beneficial in exploring the peritoneal cavity in 3 patients. Intestinal resection was necessary in 10.2 %. In our experience, 50 % of midline laparotomies were performed without any intestinal resection. Fisher's test identified midline laparotomy as the only prognostic factor of postoperative morbidity. CONCLUSION: First intention exploratory laparotomy in strangulated hernia surgery was, in our study, a major cause of postoperative complication.
Référence
Hernia. 2012 Aug;16(4):405-10