İnkarsere Karın Ön Duvarı Fıtıklarında Üçüncü Basamak Hastane Deneyimi

İlhan Taş, Ebral Yi̇ği̇t, Abidin Tüzün
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Abstract

Background: This study aims to evaluate the results of incarcerated anterior abdominal wall hernia cases in which we performed emergency surgery in light of the literature. Materials and Methods: The records of 124 patients who underwent emergency surgery for incarcera-ted anterior abdominal wall hernia between January 2016 and December 2019 were retrospectively reviewed. The patients' files, computer records, epicrisis reports, surgery reports, and outpatient clinic records were evaluated. Patients; Age, gender, hernia type, location, time of admission, previous hernia surgery history, affected organs, type of anesthesia applied, surgical techniques, resection status, length of hospital stay, morbidity, and mortality rates were recorded. Results: The mean age of 124 patients was 59.47 ± 17.75 (17-94) years. Of the patients, 64 (51.6%) were female, and 60 (48.4%) were male. The mean hospital stay was 4.12±3.52 (1-19) days. Thirteen (10.5%) patients had additional disease. General anesthesia was applied to 100 (80.6%) patients, and regional anesthesia was applied to 24 (19.4%) patients. 25 patients were operated on with the diagnosis of recur-rence and 99 with the diagnosis of a primary hernia. The most frequently compressed organs in the hernia sac were the omentum (64.5%) and small intestine (32.2%). Bowel resection was performed in 16 of the patients. Mesh was applied to 90 patients during the operation. The most common hernia types were inguinal, umbilical, and incisional. 31 (13.7%) complications developed in 17 patients. Sepsis, wound infection, ileus, atelectasis, and respiratory failure were the most common. Mortality was developed in 6 (4.8%) of the patients. Conclusions: This study showed that additional disease increases morbidity in hernia cases, and intestinal resection due to strangulation increases morbidity and mortality. Therefore, patients presenting with an incarcerated hernia should be operated on as soon as possible before strangulation develops.
背景:本研究的目的是评估嵌顿前腹壁疝病例的结果,我们根据文献进行了紧急手术。材料与方法:回顾性分析2016年1月至2019年12月接受嵌顿性前腹壁疝急诊手术的124例患者的资料。对患者档案、计算机记录、发病报告、手术报告和门诊记录进行评估。病人;记录患者的年龄、性别、疝类型、位置、入院时间、既往疝手术史、受影响器官、麻醉类型、手术技术、切除情况、住院时间、发病率和死亡率。结果:124例患者平均年龄59.47±17.75(17-94)岁。其中女性64例(51.6%),男性60例(48.4%)。平均住院时间为4.12±3.52 (1-19)d。13例(10.5%)患者有附加疾病。全麻100例(80.6%),区域麻醉24例(19.4%)。25例诊断为复发,99例诊断为原发性疝。疝囊内最常受压迫的器官是大网膜(64.5%)和小肠(32.2%)。16例患者行肠切除术。术中应用补片90例。最常见的疝类型是腹股沟、脐和切口。17例发生并发症31例(13.7%)。脓毒症、伤口感染、肠梗阻、肺不张和呼吸衰竭是最常见的。6例(4.8%)患者出现死亡。结论:本研究表明,额外的疾病增加了疝病例的发病率,肠绞窄切除术增加了发病率和死亡率。因此,出现嵌顿疝的患者应在发生绞窄之前尽快进行手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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