Increased length of incarcerated small bowel as a risk factor for intestinal necrosis in obturator hernia.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2024-12-02 DOI:10.1007/s10029-024-03234-2

Yoshiyuki Kiyasu, Naoki Oka, Makio Mike, Hiroshi Kusanagi

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引用次数: 0

Abstract

Background: Incarcerated obturator hernia (OH) is a rare type of pelvic wall hernia. With the increasing adoption of reduction techniques for incarcerated OH, it is crucial to assess the extent of damage to the incarcerated intestine. This study aimed to identify objective risk factors for intestinal necrosis based on computed tomography (CT) findings.

Methods: From October 2004 to June 2013, data from consecutive patients diagnosed with incarcerated OH at Kameda Medical Center were collected. All patients underwent laparotomy and were classified into either the viable group (no incarceration-related intestinal damage) or the necrosis group (incarceration-related intestinal damage present). Patient characteristics and CT findings were retrieved retrospectively, including incarcerated intestine length, obturator canal width, and precise location of incarceration. Multivariate logistic regression with backward elimination was performed to identify risk factors for intestinal necrosis.

Results: A total of 37 patients were included, with 25 in the viable group and 12 in the necrosis group. Multivariate analysis revealed that increased incarcerated intestine length on CT was significantly associated with necrosis (p = 0.004; odds ratio, 1.19 per 1-mm increase; 95% confidence interval, 1.06-1.34), outweighing other factors such as white blood cell count, C-reactive protein levels, and time from onset to hospital arrival.

Conclusion: Length of the incarcerated small bowel on CT may be a potential risk factor for intestinal necrosis in patients with OH.

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嵌顿小肠长度增加是闭孔疝肠坏死的危险因素。

背景：嵌顿性闭孔疝是一种罕见的骨盆壁疝。随着对嵌顿羟基的还原技术越来越多的采用，评估嵌顿肠的损伤程度是至关重要的。本研究旨在根据计算机断层扫描（CT）结果确定肠坏死的客观危险因素。方法：收集2004年10月至2013年6月在Kameda医疗中心诊断为嵌顿性OH的连续患者的数据。所有患者均行剖腹手术，分为存活组（无嵌顿相关肠损伤）和坏死组（存在嵌顿相关肠损伤）。回顾性检索患者特征和CT表现，包括嵌顿肠长度、闭孔管宽度和嵌顿的精确位置。采用多因素logistic回归并反向消除来确定肠坏死的危险因素。结果：共纳入37例患者，其中存活组25例，坏死组12例。多因素分析显示，CT上嵌顿肠长度增加与坏死显著相关(p = 0.004；优势比，每增加1毫米1.19；95%可信区间，1.06-1.34)，超过了其他因素，如白细胞计数、c反应蛋白水平和从发病到到达医院的时间。结论：CT上嵌顿小肠的长度可能是OH患者肠坏死的潜在危险因素。

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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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.