Clinical study of inguinal and femoral incarcerated hernias.
OBJECTIVE
Inguinal and femoral hernias are common disorders associated with aging. Incarcerated external hernias, however, are often fatal. This study investigated the prognostic factors in patients with incarcerated hernias.


METHODS
The study reviewed 38 patients (aged 35-97 years) diagnosed with incarcerated hernias who underwent emergency surgery. The patients were divided into those with or without a small intestinal resection, and they were then analyzed according to time from onset of symptoms to surgery.


RESULTS
The time from symptom onset to surgery was significantly longer in the resection group than in the group without resection. The patients were divided into those treated within or after 12 h using a receiver-operating characteristic curve. A sensitivity of 71.4% and a specificity of 83.4% were obtained using the time from symptom onset to operation of 12 h as a cutoff value. More patients who underwent surgery after 12 h from the onset of symptoms required an intestinal resection. Patients who underwent surgery later than 12 h after the onset of symptoms also stayed in the hospital longer than those operated on within 12 h.


CONCLUSIONS
The amount of time that elapses from the onset of symptom to surgery is considered to be an important prognostic factor in patients with incarcerated hernias. Early diagnosis and early treatment are therefore necessary in such patients.
Department of General Surgical Science (Surgery 1), Gunma University, Graduate School of Medicine, 3-39-22 Showamachi, Maebashi, Gunma, 371-8511, Japan.
Naritaka
N
Tanaka
Nobuyuki
N
Uchida
Hiroshi
H
Ogihara
Hajime
H
Sasamoto
Hiroyuki
H
Kato
Hiroyuki
H
Kuwano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004630:Emergencies; D005260:Female; D006550:Hernia, Femoral / Q000601:surgery*; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D013997:Time Factors