Treatment outcomes of Kugel repair for obturator hernias: a retrospective study
Autor: | Yoshie Hosoi, Hiroyuki Fukano, Nozomi Shinozuka, Hiroshi Asano |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Exploratory laparotomy medicine.medical_treatment Perforation (oil well) Operative Time lcsh:Surgery Peritonitis 030230 surgery 03 medical and health sciences 0302 clinical medicine Postoperative Complications Medicine Humans Iliac spine Obturator hernia Aged Retrospective Studies Aged 80 and over business.industry Mortality rate Hernia Obturator Retrospective cohort study General Medicine lcsh:RD1-811 Length of Stay Middle Aged Surgical Mesh medicine.disease Surgery Bowel obstruction Kugel repair medicine.anatomical_structure Treatment Outcome Intestinal Perforation 030220 oncology & carcinogenesis Female business Preperitoneal approach Intestinal Obstruction Surgical site infection Research Article |
Zdroj: | BMC Surgery, Vol 20, Iss 1, Pp 1-5 (2020) BMC Surgery |
ISSN: | 1471-2482 |
Popis: | Background We examined the validity and applicability of the Kugel repair approach for obturator hernias, whereby we placed a Kugel patch through the preperitoneal space after placing a short 5-cm skin incision just medial to the anterior iliac spine and 2 cm cranial to the expected origin of the internal inguinal ring. Methods We studied patients who underwent surgical Kugel repair for obturator hernias at the Department of General Surgery, Saitama Medical University between 2007 and 2017. We examined the operating time, length of hospital stay, postoperative complications, and mortality rate. Results Fifty-eight patients with obturator hernias presented with symptoms of small bowel obstruction. A Kugel approach was used in 53 patients and a midline approach was used in 5 patients with preoperative peritonitis. Of the 53 patients managed using the Kugel approach, 39 did not require intestinal resection; a mesh was used in all these patients. In the remaining 14 patients, intestinal resection was required and performed using the same approach; subsequently, a mesh was used successfully in 6 of these 14 patients. The overall median operating time was 47 min; the corresponding values for procedures with and without intestinal resection were 39 and 68 min, respectively. In terms of postoperative complications, operative mortality was not noted among patients without intestinal perforation; however, superficial surgical site infection developed in 2 patients. Among the 5 patients with preoperative peritonitis who underwent exploratory laparotomy via a midline incision, intestinal perforation was detected during surgery, and all patients required intestinal resection; none of the patients had received a mesh, and 2 patients died after surgery. Conclusions The Kugel repair approach was possible even in patients with obturator hernia requiring intestinal resection. However, for patients with perforations, open surgery should be performed after securing the surgical field through a midline incision. |
Databáze: | OpenAIRE |
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