Predictive Factors of Bowel Resection Due to an Incarcerated Groin Hernia

Abstract Purpose In this retrospective study, we assessed factors that can be used to predict the need for bowel resection due to an incarcerated groin hernia. Methods We enrolled a total of 83 patients diagnosed with an incarcerated groin hernia on preoperative unenhanced computed tomography (CT) between January 2010 and December 2019 in our hospital. They were divided into two groups: those who underwent bowel resection and those who did not. The clinical findings, blood test results, and unenhanced CT values of patients were examined and compared between the two groups. The indication of intestinal resection was macroscopic necrosis or perforation of the incarcerated intestine. Results A total of 83 patients with incarcerated groin hernias were included in our study, of whom 13 (15.7%) had undergone bowel resection surgery. A univariate analysis identified a prolonged time from the symptom onset to surgery, increased white blood cell (WBC) count, increased C-reactive protein (CRP) level, decreased albumin level, and CT attenuation of the incarcerated intestinal wall at the fundus as significant predictive factors. The cut-off value for prediction of intestinal resection was 25 HU for the average CT attenuation of the incarcerated intestinal wall at the fundus and a WBC of 11,550 based on the receiver operating characteristic (ROC) curve. A multivariate analysis showed CT attenuation of the incarcerated intestinal wall at the fundus and an increased WBC count to be independent predictive factors. Conclusions Measuring unenhanced CT attenuation of the incarcerated intestinal wall at the fundus and the WBC count was suggested to be necessary for determining whether or not resection of the incarcerated intestine is required in cases of groin hernia.

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Analysis of risk factors associated bowel resection in patients with incarcerated groin hernia

Medicine ◽

10.1097/md.0000000000020629 ◽

2020 ◽

Vol 99 (23) ◽

pp. e20629

Author(s):

Peng Chen ◽

Wenming Yang ◽

Jianhao Zhang ◽

Cun Wang ◽

Yongyang Yu ◽

...

Keyword(s):

Risk Factors ◽

Groin Hernia ◽

Bowel Resection ◽

Factors Associated ◽

Incarcerated Groin Hernia

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A Case of Necrotizing Fasciitis Asssociated with an Incarcerated Groin Hernia

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.76.1787 ◽

2015 ◽

Vol 76 (7) ◽

pp. 1787-1791

Author(s):

Noritoshi MIZUTA ◽

Kensuke NAKATANI ◽

Shinichirou OKADA ◽

Toshiyuki SUGANUMA

Keyword(s):

Necrotizing Fasciitis ◽

Groin Hernia ◽

Incarcerated Groin Hernia

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Neutrophil-to-Lymphocyte Ratio Predicts the Severity of Incarcerated Groin Hernia

Medical Science Monitor ◽

10.12659/msm.905728 ◽

2017 ◽

Vol 23 ◽

pp. 5558-5563 ◽

Cited By ~ 6

Author(s):

Xingming Xie ◽

Shu Feng ◽

Zhongling Tang ◽

Longyu Chen ◽

Yongsheng Huang ◽

...

Keyword(s):

Groin Hernia ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Incarcerated Groin Hernia

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An assessment of operative procedures in patients with incarcerated groin hernia for which intestinal resection is performed at the tane general hospital

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) ◽

10.3919/jjsa.73.1043 ◽

2012 ◽

Vol 73 (5) ◽

pp. 1043-1048

Author(s):

Tetsuya SHIROTA ◽

Makoto WATASE ◽

Mikio NANBARA ◽

Ryou TANAKA ◽

Takuya YAMAGUCHI ◽

...

Keyword(s):

General Hospital ◽

Groin Hernia ◽

Intestinal Resection ◽

Operative Procedures ◽

Incarcerated Groin Hernia

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Trends in Emergent Groin Hernia Repair—An Analysis From the Herniamed Registry

Frontiers in Surgery ◽

10.3389/fsurg.2021.655755 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ferdinand Köckerling ◽

Till Heine ◽

Daniela Adolf ◽

Konstaninos Zarras ◽

Dirk Weyhe ◽

...

Keyword(s):

Mortality Rate ◽

Hernia Repair ◽

Groin Hernia ◽

Bowel Resection ◽

Emergency Admission ◽

Female Gender ◽

Developed Countries ◽

Perioperative Outcomes ◽

Groin Hernia Repair ◽

Gender And Age

Introduction: While the proportion of emergency groin hernia repairs in developed countries is 2.5–7.7%, the percentage in developing countries can be as high as 76.9%. The mortality rate for emergency groin hernia repair in developed countries is 1.7–7.0% and can rise to 6–25% if bowel resection is needed. In this present analysis of data from the Herniamed Registry, patients with emergency admission and operation within 24 h are analyzed.Methods: Between 2010 and 2019 a total of 13,028 patients with emergency admission and groin hernia repairs within 24 h were enrolled in the Herniamed Registry. The outcome results were assigned to the year of repair and summarized as curves. The total patient collective is broken down into the subgroups with pre-operative manual reduction (taxis) of the hernia content, operative reduction of the hernia content without bowel resection and with bowel resection. The explorative Fisher's exact test was used for statistical assessment of significant differences with Bonferroni adjustment for multiple testing.Results: The proportion of emergency admissions with groin hernia repair within 24 h was 2.7%. The percentage of women across the years was consistently 33%. The part of femoral hernias was 16%. The proportion of patients with pre-operative reduction (taxis) remained unchanged at around 21% and the share needing bowel resection was around 10%. The proportion of TAPP repairs rose from 21.9% in 2013 to 38.0% in 2019 (p < 0.001). Between the three groups with pre-operative taxis, without bowel resection and with bowel resection, highly significant differences were identified between the patients with regard to the rates of post-operative complications (4% vs. 6.5% vs. 22.7%; p < 0.0001), complication-related reoperations (1.9% vs. 3.8% vs. 17.7%; p < 0.0001), and mortality rate (0.3% vs. 0.9% vs. 7.5%; p < 0.001). In addition to emergency groin hernia repair subgroups female gender and age ≥66 years are unfavorable influencing factors for perioperative outcomes.Conclusion: For patients with emergency groin hernia repair the need for surgical reduction or bowel resection, female gender and age ≥66 years have a highly significantly unfavorable influence on the perioperative outcomes.

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