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Excellent outcomes after emergency groin hernia repair.
Hernia. 2010 Oct; 14(5):485-8.H

Abstract

PURPOSE

Emergency repair of incarcerated inguinal and femoral hernias has traditionally been regarded as carrying an increased risk of morbidity and mortality in a patient population that tends to be elderly with significant co-morbidities. Excessive waiting times for elective repair and delays in diagnosis and treatment increase the risk of strangulation, bowel resection and overall mortality. This study examined the management of emergency surgery for groin hernias for a 3 year period in a large teaching hospital.

METHOD

The notes of all patients undergoing emergency groin hernia repair in our hospital between 1 January 2005 and 31 December 2007 were examined. Patient demographics and details of perioperative course and outcome were analysed.

RESULTS

Seventy-nine (50 males) patients had emergency groin hernia repair in the 3 year study period. Inguinal hernias predominated (61 vs 18); 12/79 (15%) had previously been assessed as outpatients prior to emergency presentation-all had inguinal hernias and nine (11.4 %) were on the waiting list for elective repair at the time of emergency surgery (mean wait 59 days). Complications were observed in 24% of patients. Two patients (2.5%) required small bowel resection, both performed without recourse to formal laparotomy, and two patients died within 30 days of surgery (2.5%).

CONCLUSIONS

It is possible to achieve excellent complication, bowel resection and 30-day mortality rates in emergency groin hernia repair even in patients who have previously declined surgery due to perceived anaesthetic risks. As NHS waiting times for surgery decrease, the number of hernias repaired emergently whilst awaiting elective surgery will also fall.

Authors+Show Affiliations

Department of Colorectal Surgery, Northern General Hospital, Sheffield Teaching Hospitals Foundation NHS Trust, Sheffield, UK. jtiernan@doctors.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20443125

Citation

Tiernan, J P., et al. "Excellent Outcomes After Emergency Groin Hernia Repair." Hernia : the Journal of Hernias and Abdominal Wall Surgery, vol. 14, no. 5, 2010, pp. 485-8.
Tiernan JP, Katsarelis H, Garner JP, et al. Excellent outcomes after emergency groin hernia repair. Hernia. 2010;14(5):485-8.
Tiernan, J. P., Katsarelis, H., Garner, J. P., & Skinner, P. P. (2010). Excellent outcomes after emergency groin hernia repair. Hernia : the Journal of Hernias and Abdominal Wall Surgery, 14(5), 485-8. https://doi.org/10.1007/s10029-010-0667-y
Tiernan JP, et al. Excellent Outcomes After Emergency Groin Hernia Repair. Hernia. 2010;14(5):485-8. PubMed PMID: 20443125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Excellent outcomes after emergency groin hernia repair. AU - Tiernan,J P, AU - Katsarelis,H, AU - Garner,J P, AU - Skinner,P P, Y1 - 2010/05/05/ PY - 2010/01/04/received PY - 2010/04/16/accepted PY - 2010/5/6/entrez PY - 2010/5/6/pubmed PY - 2011/1/19/medline SP - 485 EP - 8 JF - Hernia : the journal of hernias and abdominal wall surgery JO - Hernia VL - 14 IS - 5 N2 - PURPOSE: Emergency repair of incarcerated inguinal and femoral hernias has traditionally been regarded as carrying an increased risk of morbidity and mortality in a patient population that tends to be elderly with significant co-morbidities. Excessive waiting times for elective repair and delays in diagnosis and treatment increase the risk of strangulation, bowel resection and overall mortality. This study examined the management of emergency surgery for groin hernias for a 3 year period in a large teaching hospital. METHOD: The notes of all patients undergoing emergency groin hernia repair in our hospital between 1 January 2005 and 31 December 2007 were examined. Patient demographics and details of perioperative course and outcome were analysed. RESULTS: Seventy-nine (50 males) patients had emergency groin hernia repair in the 3 year study period. Inguinal hernias predominated (61 vs 18); 12/79 (15%) had previously been assessed as outpatients prior to emergency presentation-all had inguinal hernias and nine (11.4 %) were on the waiting list for elective repair at the time of emergency surgery (mean wait 59 days). Complications were observed in 24% of patients. Two patients (2.5%) required small bowel resection, both performed without recourse to formal laparotomy, and two patients died within 30 days of surgery (2.5%). CONCLUSIONS: It is possible to achieve excellent complication, bowel resection and 30-day mortality rates in emergency groin hernia repair even in patients who have previously declined surgery due to perceived anaesthetic risks. As NHS waiting times for surgery decrease, the number of hernias repaired emergently whilst awaiting elective surgery will also fall. SN - 1248-9204 UR - https://www.unboundmedicine.com/medline/citation/20443125/Excellent_outcomes_after_emergency_groin_hernia_repair_ L2 - https://dx.doi.org/10.1007/s10029-010-0667-y DB - PRIME DP - Unbound Medicine ER -