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. 2019 Aug;43(8):1906-1913.
doi: 10.1007/s00268-019-04989-x.

Risk Factors for Incarceration in Patients with Primary Abdominal Wall and Incisional Hernias: A Prospective Study in 4472 Patients

Dimitri Sneiders #  1   2 , Yagmur Yurtkap #  3 , Leonard F Kroese  4 , Gert-Jan Kleinrensink  5 , Johan F Lange  3   6 , Jean-François Gillion  7 ; Hernia-Club Members
Collaborators, Affiliations

Risk Factors for Incarceration in Patients with Primary Abdominal Wall and Incisional Hernias: A Prospective Study in 4472 Patients

Dimitri Sneiders et al. World J Surg. 2019 Aug.

Abstract

Background: Incarceration of primary and incisional hernias often results in emergency surgery. The objective of this study was to evaluate the relation of defect size and location with incarceration. Secondary objectives comprised identification of additional patient factors associated with an incarcerated hernia.

Methods: A registry-based prospective study was performed of all consecutive patients undergoing hernia surgery between September 2011 and February 2016. Multivariate logistic regression was performed to identify risk factors for incarceration.

Results: In total, 83 (3.5%) of 2352 primary hernias and 79 (3.7%) of 2120 incisional hernias had a non-reducible incarceration. For primary hernias, a defect width of 3-4 cm compared to defects of 0-1 cm was significantly associated with an incarcerated hernia (OR 2.85, 95% CI 1.57-5.18, p = 0.0006). For incisional hernias, a defect width of 3-4 cm compared to defects of 0-2 cm was significantly associated with an incarceration (OR 2.14, 95% CI 1.07-4.31, p = 0.0324). For primary hernias, defects in the peri- and infra-umbilical region portrayed a significantly increased odds for incarceration as compared to supra-umbilical defects (OR 1.98, 95% CI 1.02-3.85, p = 0.043). Additionally, in primary hernias age, BMI, and constipation were associated with incarceration. In incisional hernias age, BMI, female sex, diabetes mellitus and ASA classification were associated with incarceration.

Conclusion: For primary and incisional hernias, mainly defects of 3-4 cm were associated with incarceration. For primary hernias, mainly defects located in the peri- and infra-umbilical region were associated with incarceration. Based on patient and hernia characteristics, patients with increased odds for incarceration may be selected and these patients may benefit from elective surgical treatment.

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References

    1. van Ramshorst GH et al (2012) Impact of incisional hernia on health-related quality of life and body image: a prospective cohort study. Am J Surg 204(2):144–150 - DOI - PubMed
    1. Li LT et al (2014) Outcomes of acute versus elective primary ventral hernia repair. J Trauma Acute Care Surg 76(2):523–528 - DOI - PubMed
    1. Chung PJ et al (2017) Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database. Hernia 21(3):323–333 - DOI - PubMed
    1. Mueck KM et al (2017) Computed tomography findings associated with the risk for emergency ventral hernia repair. Am J Surg 214(1):42–46 - DOI - PubMed
    1. Jensen KK, Erichsen R, Krarup PM (2017) The impact of incisional hernia on mortality after colonic cancer resection. Surg Endosc 31(5):2149–2154 - DOI - PubMed

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