Inguinal hernia: Challenging the traditional indication for surgery in asymptomatic patients

被引:26
作者
Ohana G. [1 ,2 ]
Manevwitch I. [1 ,2 ]
Weil R. [1 ,2 ]
Melki Y. [1 ,2 ]
Seror D. [1 ,2 ]
Powsner E. [1 ,2 ]
Dreznik Z. [1 ,2 ]
机构
[1] Division of Surgery, Rabin Medical Center, Petach Tiqva, Golda Campus
[2] Sackler School of Medicine, Tel Aviv University, Tel Aviv
关键词
Asymptomatic; Bowel resection; Incarcerated; Inguinal hernia; Mortality;
D O I
10.1007/s10029-003-0184-3
中图分类号
学科分类号
摘要
Background: It is generally accepted that most inguinal hernias should be operated on electively in order to avoid the high morbidity and mortality associated with incarceration and small bowel obstruction. The present study reassesses the indication for surgery in asymptomatic inguinal hernia patients. Methods: We analyzed profiles, separately, for elective and emergency inguinal herniorrhaphies and compared the morbidity and mortality rates. Results: Two hundred randomly selected elective hernia repairs were compared with 67 incarcerated cases. Postoperative complications were more common following emergency (23.9%) than elective repair (10.5%); however, in both groups, minor complications predominated. The mortality rate in the incarcerated group (6%) was clearly linked with a high preoperative American Society of Anesthesiologists (ASA) score. A bowel resection rate of 4.5% was found in the incarcerated cases, which was not correlated with mortality. Conclusions: Patients with asymptomatic inguinal hernia and unfavorable medical conditions should be recommended an elective repair, preferably under local anesthesia, to avoid the high mortality associated with an emergency operation. © Springer-Verlag 2003.
引用
收藏
页码:117 / 120
页数:3
相关论文
共 20 条
[1]  
Akcakaya A., Alimoglu O., Hevenk T., Bas G., Sahin M., Mechanical intestinal obstruction caused by abdominal wall hernias, Ulus. Travma. Derg., 6, pp. 260-265, (2000)
[2]  
Broll R., Weisser C., Muhlschlegel M., Inguinal hernia in old age, Dtsch. Med. Wochenschr., 112, pp. 641-643, (1987)
[3]  
Kulah B., Duzgun A.P., Moran M., Kulacoglu I.H., Ozmen M.M., Coskun F., Emergency hernia repairs in elderly patients, Am. J. Surg., 182, pp. 455-459, (2001)
[4]  
Lewis D.C., Moran C.G., Vellacott K.D., Inguinal hernia repair in the elderly, J. R. Coll. Surg. Edinb., 34, pp. 101-103, (1989)
[5]  
Millat B., Treatment of inguinal hernia: Indications, Rev. Prat., 47, pp. 268-272, (1997)
[6]  
Post S., Against the principle surgical indications in inguinal hernia, Chirurg., 68, pp. 1256-1257, (1997)
[7]  
Primatesta P., Goldacre M.J., Inguinal hernia repair: Incidence of elective and emergency surgery, readmission and mortality, Int. J. Epidemiol., 25, pp. 835-839, (1996)
[8]  
Forte A., D'Urso A., Palumbo P., Lo Storto G., Gallinaro L., Bezzi M., Beltrami V., Inguinal hernioplasty: The gold standard of hernia repair, Hernia, 7, pp. 35-38, (2003)
[9]  
Kurt N., Oncel M., Ozkan Z., Bingul S., Risk and outcome of bowel resection in patients with incarcerated groin hernias: Retrospective study, World J. Surg., 27, pp. 741-743, (2003)
[10]  
Harouna Y., Yaya H., Abdou I., Bazira L., Prognosis of strangulated inguinal hernia in the adult: Influence of intestinal necrosis. Apropos of 34 cases, Bull. Soc. Pathol. Exot., 93, pp. 317-320, (2000)