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01-05-2021 | Femoral Hernia | Original Article

Bowel obstruction as a serious complication of patients with femoral hernia

Authors: Mauricio Gonzalez-Urquijo, Valeria C. Tellez-Giron, Emmanuel Martinez-Ledesma, Mario Rodarte-Shade, Oscar J. Estrada-Cortinas, Gerardo Gil-Galindo

Published in: Surgery Today | Issue 5/2021

Abstract

Purpose

The implications of bowel obstruction occurring secondary to femoral hernia have not been discussed in the literature recently. Thus, we report our experience of treating patients with femoral hernias complicated by bowel obstruction versus patients with femoral hernias not complicated by bowel obstruction.

Methods

The subjects of this retrospective study were patients admitted to our hospital for the treatment of femoral hernias between 2016 and 2019. We used the Fisher and Student’s T test to compare the preoperative characteristics, treatment, and outcomes of patients with bowel obstruction versus those without bowel obstruction.

Results

A total of 53 patients (mean age, 66.9 ± 15.1 years) were treated, 18 (33.9%) of whom underwent elective surgery and 35 (66%) of whom required emergency surgery (p = 0.001). The mean time between the development of symptoms and hospitalization was 4.5 ± 3.1 days for the patients with bowel obstruction and 1.6 ± 3.2 days for those without bowel obstruction (p = 0.001). The length of hospital stay was 11.1 ± 21.1 days for the patients with bowel obstruction and 1 ± 1.8 days for those without bowel obstruction (p = 0.028). Overall morbidity and mortality rates were 13.2% and 5.6%, respectively.

Conclusion

Femoral hernias causing bowel obstruction are associated with greater time between the development of symptoms, hospitalization, and with a longer hospital stay.

Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G, et al. Femoral hernia: a review of 83 cases. Hernia. 2006;10:70–3. https://doi.org/10.1007/s10029-005-0045-3.CrossRefPubMed

Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U. Emergency femoral hernia repair. Ann Surg. 2009;249:672–6. https://doi.org/10.1097/SLA.0b013e31819ed943.CrossRefPubMed

Suppiah A, Gatt M, Barandiaran J, Heng M, Perry E. Outcomes of emergency and elective femoral hernia surgery in four district general hospitals : a 4-year study. Hernia. 2007;11:509–12. https://doi.org/10.1007/s10029-007-0262-z.CrossRefPubMed

Ihedioha U, Alani A, Modak P, Chong P. Hernias are the most common cause of strangulation in patients presenting with small bowel obstruction. Hernia. 2006;10:338–40. https://doi.org/10.1007/s10029-006-0101-7.CrossRefPubMed

Brittenden J, Heys SD, Eremin O. Femoral hernia: mortality and morbidity following elective and emergency surgery. J R Coll Surg Edinb. 1991;36:86–8.PubMed

Chamary L. FemoraI hernia : intestinal obstruction is an unrecognized source of morbidity and mortality. Br J Surg. 1993;80:230–2.CrossRef

Nilsson H, Nilsson E, Angeras U, Nordin P. Mortality after groin hernia surgery: delay of treatment and cause of death. Hernia. 2011;15:301–7. https://doi.org/10.1007/s10029-011-0782-4.CrossRefPubMed

Andresen K, Bisgaard T, Kehlet H, Wara P, Rosenberg J. Reoperation rates for laparoscopic vs open repair of femoral hernias in Denmark: a nationwide analysis. JAMA Surg. 2014;149:853–7. https://doi.org/10.1001/jamasurg.2014.177.CrossRefPubMed

Liu X, Ye L, Zheng G, Ye B, Chen W, Xie H, et al. A retrospective cohort study of open preperitoneal repair versus open suture repair for the treatment of emergency femoral hernia. Sci Rep. 2020;10:1–7. https://doi.org/10.1038/s41598-020-60722-y.CrossRef

10.

Clyde D, de Beaux A, Tulloh B, Neill JRO. Minimising recurrence after primary femoral hernia repair; is mesh mandatory? Hernia. 2019. https://doi.org/10.1007/s10029-019-02007-6.CrossRefPubMed

11.

Tastaldi L, Krpata DM, Prabhu AS, Petro CC, Ilie R, Haskins IN, et al. Emergent groin hernia repair: a single center 10-year experience. Surgery. 2018;0:1–8. https://doi.org/10.1016/j.surg.2018.08.001.CrossRef

12.

Kjaergaard J, Bay-Nielsen M, Kehle H. Mortality following emergency groin hernia surgery in Denmark. Hernia. 2010;14:351–5. https://doi.org/10.1007/s10029-010-0657-0.CrossRefPubMed

13.

Hachisuka T. Femoral hernia repair. Surg Clin North Am. 2003;83:1189–205. https://doi.org/10.1016/S0039-6109(03)00120-8.CrossRefPubMed

14.

Teixeira PG, Karamanos E, Talving P, Inaba K, Lam L, Demetriades D, et al. Early operation is associated with a survival benefit for patients. Ann Surg. 2013;258:459–65. https://doi.org/10.1097/SLA.0b013e3182a1b100.CrossRefPubMed

15.

Schraufnagel D, Rajaee S, Millham FH. How many sunsets? Timing of surgery in adhesive small bowel obstruction: a study of the nationwide inpatient sample. J Trauma Acute Care Surg. 2012;74:181–9. https://doi.org/10.1097/TA.0b013e31827891a1.CrossRef

16.

Hashimoto D, Hirota M, Matsukawa T, Yagi Y, Baba H. Clinical features of strangulated small bowel obstruction. Surg Today. 2012;42:1061–5. https://doi.org/10.1007/s00595-012-0207-8.CrossRefPubMed

17.

Bouassida M, Laamiri G, Zribi S, Slama H, Mroua B. Predicting intestinal ischaemia in patients with adhesive small bowel obstruction: a simple score. World J Surg. 2020. https://doi.org/10.1007/s00268-020-05377-6.CrossRefPubMed

18.

Swarnkar K, Hopper N, Nelson M, Feroz A, Stephenson BM. Sutureless mesh-plug femoral hernioplasty. Am J Surg. 2003;186:201–2. https://doi.org/10.1016/s0002-9610(03)00178-8.CrossRefPubMed

19.

Dai W, Chen Z, Zuo J, Tan J, Tan M, Yuan Y. Risk factors of postoperative complications after emergency repair of incarcerated groin hernia for adult patients: a retrospective cohort study. Hernia. 2018. https://doi.org/10.1007/s10029-018-1854-5.CrossRefPubMedPubMedCentral

20.

Bessa SS, Abdel-fattah M, Al-Sayes I, Korayem IT. Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and / or strangulated groin hernias: a 10-year study. Hernia. 2015. https://doi.org/10.1007/s10029-015-1360-y.CrossRefPubMed

21.

Lockhart K, Dunn D, Teo S, Ng JY, Dhillon M, Teo E, et al. Mesh versus non-mesh for inguinal and femoral hernia repair. Cochrane Database Syst Rev. 2018;9:CD011517. https://doi.org/10.1002/14651858.CD011517.pub2.CrossRefPubMed

22.

Murphy B, UbI D, Zhang J, Habermann E, Farley D, Paley K. Proportion of femoral hernia repairs performed for recurrence in the United States. Hernia. 2018. https://doi.org/10.1007/s10029-018-1743-y.CrossRefPubMed

23.

Nicholson S, Keane TE, Devlin HB. Short note femoral hernia: an avoidable source of surgical mortality. Br J Surg. 1990;77:307–8.CrossRef

Title: Bowel obstruction as a serious complication of patients with femoral hernia
Authors: Mauricio Gonzalez-Urquijo
Valeria C. Tellez-Giron
Emmanuel Martinez-Ledesma
Mario Rodarte-Shade
Oscar J. Estrada-Cortinas
Gerardo Gil-Galindo
Publication date: 01-05-2021
Publisher: Springer Singapore
Keyword: Femoral Hernia
Published in: Surgery Today / Issue 5/2021
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-020-02158-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Bowel obstruction as a serious complication of patients with femoral hernia

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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