Hernia : the journal of hernias and abdominal wall surgery · 2016
Emergency femoral hernia repair: 13-year retrospective comparison of the three classical open surgical approaches.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Chia C F, Chan W H, Yau K W, Chan Cko
Аннотация
PURPOSE AND METHODS: Femoral hernia repairs have been done classically with three different open approaches, namely the Lockwood's (LW), Lotheissen's (LT) and McEvedy's (ME) approaches. Current literature has yet provided any definite conclusion over the best approach in emergency situations. This study aims to evaluate and compare the operative outcomes of these three approaches in emergency situations by retrospectively analyzing 190 cases (76 ME, 33 LT, 81 LW) in 13 years at a regional surgical center.
RESULTS: Significantly less laparotomies were required for McEvedy's approach (ME 2.6% vs LT 33.3% vs LW 43.2%, p < 0.001), despite the need for bowel resection appear to be higher (ME 43.4% vs LT 27.3% vs LW 27.2%, p = 0.072). Overall hernia recurrence (p = 0.657) and surgical complication rates (p = 0.585) were similar between the three approaches. Although not reaching statistical significance, it appeared that in patients undergoing McEvedy's operation, mean length of stay was longer (ME 10.1 days vs LT 7.4 days vs LW 9.2 days, p = 0.407) and required more operation time (ME 97.4 min vs LT 72.0 min vs LW 79.0 min, p = 0.222).
CONCLUSIONS: All three approaches were safe and effective in repairing femoral hernias in the emergency setting. McEvedy's approach may be superior to others when entry into the peritoneum is anticipated, although it may potentially be associated with longer operation time and hospital stay.
RESULTS: Significantly less laparotomies were required for McEvedy's approach (ME 2.6% vs LT 33.3% vs LW 43.2%, p < 0.001), despite the need for bowel resection appear to be higher (ME 43.4% vs LT 27.3% vs LW 27.2%, p = 0.072). Overall hernia recurrence (p = 0.657) and surgical complication rates (p = 0.585) were similar between the three approaches. Although not reaching statistical significance, it appeared that in patients undergoing McEvedy's operation, mean length of stay was longer (ME 10.1 days vs LT 7.4 days vs LW 9.2 days, p = 0.407) and required more operation time (ME 97.4 min vs LT 72.0 min vs LW 79.0 min, p = 0.222).
CONCLUSIONS: All three approaches were safe and effective in repairing femoral hernias in the emergency setting. McEvedy's approach may be superior to others when entry into the peritoneum is anticipated, although it may potentially be associated with longer operation time and hospital stay.