title: Femoral hernia: is a conservative policy justified?
abstract: OBJECTIVE
  To find out the incidence of complications among patients who present with femoral hernias and whether they are preventable.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Teaching hospital, The Netherlands.
  
  
  METHODS
  111 patients whose femoral hernias were operated on between 1 January 1983 and 31 June 1994.
  
  
  METHODS
  Emergency (n = 33) and elective repair (n = 78).
  
  
  METHODS
  Morbidity and mortality, and associated factors.
  
  
  RESULTS
  Patients who underwent emergency repair were significantly older (median age 77 years, range 28-106 compared with 54, range 19-85, p < 0.001), were more likely to have cardiopulmonary disease (14/33 compared with 6/78, p < 0.001), and were more likely to need a bowel resection (9/33 compared with 0/78, p < 0.001). Three patients died in the emergency group compared with none in the elective group.
  
  
  CONCLUSIONS
  An initial conservative policy led to higher subsequent morbidity and mortality because of the relatively high incidence of strangulation in older patients and those with cardiopulmonary disease. We therefore recommend elective repair as the treatment of choice.
authors.affiliation: Department of Surgery, Saint Elisabeth Hospital, Tilburg, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Kemler
authors.forename: H J
authors.initials: HJ
authors.lastname: Oostvogel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006550:Hernia, Femoral / Q000150:complications / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies