Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

Surgery for incarcerated hernia: short-term outcome with or without mesh

Abstract :

BACKGROUND: Incarcerated hernias represent about 5-15 % of all operated hernias. Tension-free mesh is the preferred technique for elective surgery due to low recurrence rates. There is however currently no consensus on the use of mesh for the treatment of incarcerated hernias, especially in case of bowel resection.

AIM: The aims of this study were (i) to report our current practice for the treatment of incarcerated hernias, (ii) to identify risk factors for postoperative complications, and (iii) to assess the safety of mesh placement in potentially infected surgical fields.

METHODS: This retrospective study included 166 consecutive patients who underwent emergency surgery for incarcerated hernia between January 2007 and January 2012 in two university hospitals. Demographics, surgical details, and short-term outcome were collected. Univariate analysis was employed to identify risk factors for overall, infectious, and major complications.

RESULTS: Eighty-four patients (50.6 %) presented inguinal hernias, 43 femoral (25.9 %), 37 umbilical hernias (22.3 %), and 2 mixed hernias (1.2 %), respectively. Mesh was placed in 64 patients (38.5 %), including 5 patients with concomitant bowel resection. Overall morbidity occurred in 56 patients (32.7 %), and 8 patients (4.8 %) developed surgical site infections (SSI). Univariate risk factors for overall complications were ASA grade 3/4 (P = 0.03), diabetes (P = 0.05), cardiopathy (P = 0.001), aspirin use (P = 0.023), and bowel resection (P = 0.001) which was also the only identified risk factor for SSI (P = 0.03). In multivariate analysis, only bowel incarceration was associated with a higher rate of major morbidity (OR = 14.04; P = 0.01).

CONCLUSION: Morbidity after surgery for incarcerated hernia remains high and depends on comorbidities and surgical presentation. The use of mesh could become current practice even in case of bowel resection.

Type de document :
Article dans une revue
Liste complète des métadonnées
Contributeur : Okina Univ Angers Connectez-vous pour contacter le contributeur
Soumis le : jeudi 24 juin 2021 - 11:35:14
Dernière modification le : jeudi 20 janvier 2022 - 12:18:02

Lien texte intégral




Aurélien Venara, M Hubner, P. Lenaoures, Jean-François Hamel, Antoine Hamy, et al.. Surgery for incarcerated hernia: short-term outcome with or without mesh. Langenbeck's Archives of Surgery, 2014, 399 (5), pp.571-577. ⟨10.1007/s00423-014-1202-x⟩. ⟨hal-03269744⟩



Consultations de la notice