Advantages of ultrasound-guided reduction and elective surgery versus emergency repair for incarcerated obturator hernia.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-12 DOI:10.1007/s00595-025-03014-0

Yoshiyuki Kiyasu, Naoki Oka, Makio Mike, Hiroshi Kusanagi

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引用次数: 0

Abstract

Purpose: To compare the benefits of ultrasound-guided reduction (UGR) followed by elective versus emergency repair for incarcerated obturator hernia (OH).

Methods: This is a retrospective cohort study. Before UGR implementation, all patients with incarcerated OH underwent emergency surgery. To compare the UGR candidates fairly, only patients who did not require bowel resection were classified as the emergency group. Following UGR implementation, the patients without bowel necrosis, based on our criteria, underwent UGR. Among these, those who underwent elective repair were classified into the elective group. The surgical outcomes were compared between the groups and are presented as the median (range).

Results: Among the 60 patients with incarcerated OH, 23 were in the emergency group and 11 in the elective group. UGR was successful in 16 of 17 cases (94%). The elective group had significantly shorter times to first defecation (4 [1-7] vs. 0 [0-1]) and meal initiation (3 [1-8] vs. 1 [1-3] days) than the emergency group. Although not statistically significant, the mesh repair rate was higher in the elective group (100% vs. 78%, respectively).

Conclusions: UGR can be safely performed with an appropriate diagnosis. Compared with emergency surgery, UGR followed by elective repair led to reduced postoperative ileus and elevated mesh repair rates.

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超声引导下复位和选择性手术与嵌顿性闭孔疝急诊修复的优势。

目的：比较超声引导复位（UGR）后择期与急诊修复嵌顿性闭孔疝（OH）的益处。方法：回顾性队列研究。在实施UGR之前，所有嵌顿OH患者都接受了紧急手术。为了公平地比较UGR候选者，只有不需要肠切除术的患者被归类为急诊组。在实施UGR后，根据我们的标准，没有肠坏死的患者接受了UGR。其中，择期修复者分为择期组。比较两组之间的手术结果，并以中位数（范围）表示。结果：60例OH嵌顿患者中，急诊组23例，择期组11例。17例中有16例UGR成功（94%）。择期组首次排便时间（4 [1-7]vs. 0[0-1]）和开始进食时间（3 [1-8]vs. 1[1-3]天）明显短于急诊组。虽然没有统计学意义，但选择性组的补片修复率更高（分别为100%和78%）。结论：在适当的诊断下，UGR可以安全进行。与急诊手术相比，UGR术后选择性修复减少了术后肠梗阻，提高了补片修复率。

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

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.