İnkarsere Karın Duvarı Fıtıklarında Morbite ve Mortaliteye Etkili Faktörler

Factors affecting morbidity and mortality in incarcerated abdominal wall hernias

Journal Hernia

Publisher Springer Paris

ISSN 1265-4906 (Print) 1248-9204 (Online)

Status

Category Original Article

DOI 10.1007/s10029-007-0226-3

Subject Collection Medicine

SpringerLink Date

Wednesday, April 18, 2007

Hayrullah Derici, Haluk Recai Ünalp, Ali Doğan Bozdağ, Okay Nazli, Tuğrul Tansug, Erdinç Kamer

3rd General Surgery Clinic, Atatürk Training and Research Hospital, Izmir, Turkey

4th General Surgery Clinic, Atatürk Training and Research Hospital, Izmir, Turkey

Received: 23 October 2006

Accepted: 15 March 2007

Published online: 18 April 2007

Abstract

Background: Incarcerated abdominal wall hernia cases may necessitate emergency interventions, but under such circumstances morbidity and mortality rates may increase. The aim of this study was to investigate the factors that affect morbidity and mortality in patients with incarcerated abdominal wall hernias who underwent emergency surgery.

Methods: Urgent surgical interventions due to incarcerated abdominal wall hernias were performed in 182 patients in our clinics between January 1998 and January 2006. Factors that affect morbidity and mortality in incarcerated abdominal wall hernias were investigated retrospectively by browsing the archives. Logistic regression analysis was used to evaluate parameters that affect morbidity and mortality.

Results: Morbidity and mortality occurred in 43 (23.6%) and 9 (4.9%) patients, respectively. A symptomatic period of longer than 8 h, presence of accompanying disease, high American Society of Anesthesiology (ASA) score, general anesthesia, presence of strangulation, and necrosis were found to affect morbidity significantly by univariate analysis. Necrosis was the sole factor affecting morbidity significantly by multivariate analysis. Advanced age, presence of accompanying disease, high ASA score, presence of strangulation, necrosis, and hernia repair with graft were found to affect mortality significantly by univariate analysis; however, necrosis was the sole factor affecting mortality significantly by multivariate analysis.

Conclusions: Intestinal necrosis, which was followed by bowel resection, was the sole factor affecting morbidity and mortality using multivariate logistic regression analysis. Emergency surgery is required for incarcerated abdominal wall hernias before intestinal necrosis develops.

Keywords: Incarceration - Hernia - Predictive factors - Morbidity - Mortality

Duyurular
Bu sayfalarda Dr. Turhan Tansuğ’un radyoloji arşivindeki çeşitli patolojilere ait konvansiyonel radyolojik görüntülerden örneklere yer verilecektir.
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