[Outcome of treatment of incarcerated hernia].
Experience in surgical treatment of 632 patients for incarcerated hernias of different localization is analysed. The patients' ages ranged from 39 to 91, 448 (70.9%) patients were over 60 years of age. Inguinal and umbilical hernias were encountered most frequently--62.5%. The intestine was resected in 93 patients, 80 of them were over 60 years of age (86%). Among these patients 63 were admitted to the clinic 1 to 4 days after the incarceration had occurred. The causes of late hospitalization: through the patient's fault in 80 (24.8%) cases, due to the doctor's errors in the prehospital stage in 39 (12.1%) cases. Kerte's method for determining the viability of the incarcerated intestine is subjective to a certain measure--the surgeons made errors in 14% of cases (confirmed histologically). The mortality was 13.4%, in 85% death occurred at an age over 70 and in 74% of cases the patients were admitted 24 hours to 4 days after the incarceration. Incompetence of the sutures of the anastomosis (41%) was the main cause of death. Late hospitalization, elderly and old age, severe concomitant complications, and unwarrantably extended volume of the interventions were the main causes of unfavorable outcomes of the management of this category of patients.
Nesterenko
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Shovskiĭ
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors; D005260:Female; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006554:Hernia, Umbilical / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
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