Factors affecting morbidity in urgent repair of abdominal wall hernia with intestinal incarceration in adults

Abstract

BACKGROUND: The aim of this study was to investigate factors that affect morbidity in adults with incarcerated intestinal hernia of the abdominal wall. METHODS: 124 patients with a mean age of 61±13.87 years (73 males) underwent emergency surgery for incarcerated intestinal hernia between March 1999 and March 2008. The median duration of the hernia was 5 years (0.1-30). Type and duration of hernia, accompanying diseases, surgical procedure, and operation-related complications were retrospectively evaluated. RESULTS: Twenty-fve patients (20%) had complications. Twelve patients (10%) had surgical site infection and 10 patients (8%) had septic complications. Four patients (3%) died in the postoperative period. Out of 40 patients developing strangulation, 18 underwent bowel resection. The only independent variable concerning bowel resection other than inguinal hernia was found to be ventral hernia (p=0.039). There was no statistical signifcance between duration of hernia and incarceration and complications. The rate of complications was signifcantly high in the patients with accompanying diseases (p<0.001). The relation between age and complications was also signifcant (p=0.034). Multivariate analyses showed high ASA scores as the only independent variable for development of complications (p<0.001). CONCLUSION: Patients with comorbid diseases and high ASA scores should be informed about the elevated risk of complications, and scheduled surgery before the development of incarceration should be recommended.