Femoral and Inguinal Hernia: How to Minimize Adverse Outcomes Following Repair

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Search: WFRF:(Wollert Staffan) > (2010-2014) > Femoral and Inguina...

Details
MARC

Dahlstrand, Ursula,1976-Uppsala universitet,Kolorektalkirurgi (author)

Femoral and Inguinal Hernia : How to Minimize Adverse Outcomes Following Repair

BookEnglish2011

Publisher, publication year, extent ...

Uppsala :Acta Universitatis Uppsaliensis,2011
57 s.
electronicrdacarrier

Numbers

LIBRIS-ID:oai:DiVA.org:uu-162203
ISBN:9789155482367
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-162203URI

Supplementary language notes

Language:English
Summary in:English

Part of subdatabase

SwePubSwePub

Classification

Subject category:vet swepub-contenttype
Subject category:dok swepub-publicationtype

Series

Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine,1651-6206 ;728

Notes

Groin hernia is common, and each year 200 repairs per 100 000 adult inhabitants are performed in Sweden. Groin hernias are either inguinal or femoral (2-4%). Elective repair is not associated with an excess mortality, but adverse outcomes include recurrence and long-term pain. Emergency procedures have a 4% mortality rate with an increased risk for bowel resection and postoperative complications. The aim of this thesis was to identify risk factors for adverse outcomes and to propose measures to improve groin hernia treatment. Twenty-three per cent of female hernias were femoral. Thirty-six per cent of femoral hernias, and 5% of inguinal hernias, have emergency procedures. Females (OR 1.47) and patients above 65 years-of-age (OR 2.24) were at higher risk for emergency repair. Bowel resection was performed in 23% of emergency femoral repairs, and the 30-day mortality was 10 times that of an age- and gender-matched population. The majority of emergency patients were unaware of their hernia, and one third had previously had no groin symptoms. Femoral repairs were at larger risk for recurrence than inguinal repairs. The surgical techniques with least risk for recurrence were preperitoneal mesh repairs (open HR 0.28, and laparoscopic HR 0.31). Long-term pain was present in 24% of femoral hernia patients, of whom 5.5% described pain interfering with daily activities. The only factor predicting the risk for long-term pain was pain preoperatively. Pain decreased with time. In a randomized study on inguinal hernia, TEP resulted in less pain six weeks after surgery than Lichtenstein repair performed under local anesthesia (LLA). TEP patients were to a larger extent able to perform sporting activities. No difference was seen in intra-operative complications. Femoral hernias should be given high priority for repair and preperitoneal techniques should be used. Earlier diagnosis, in the elective setting, is probably difficult to attain. Heightened awareness in the emergency department is required. TEP is safe, and results in less pain than LLA six weeks after surgery. A widening of indications for TEP in primary inguinal hernia repair is justifiable.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
femoral hernia
inguinal hernia
adverse outcome
complication
recurrence
chronic pain
long-term pain
emergency
mortality
TEP
Lichtenstein
local anesthesia
Surgery
Kirurgi

Added entries (persons, corporate bodies, meetings, titles ...)

Gunnarsson, UlfCLINTEC, Karolinska Institutet (thesis advisor)
Sandblom, GabrielCLINTEC, Karolinska Institutet (thesis advisor)
Wollert, StaffanUppsala universitet,Gastrointestinalkirurgi (thesis advisor)
Kingsnorth, Andrew,ProfessorUniversity of Plymouth, Peninsula College of Medicine & Dentistry (opponent)
Uppsala universitetKolorektalkirurgi (creator_code:org_t)

Internet link

Find in a library

Femoral and Inguinal Hernia How to Minimize Adverse Outcomes Following Repair (Search the publication in LIBRIS)

To the university's database

Find more in SwePub

By the author/editor: Dahlstrand, Ursu ...; Gunnarsson, Ulf; Sandblom, Gabrie ...; Wollert, Staffan; Kingsnorth, Andr ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

Parts in the series: Digital Comprehe ...

By the university: Uppsala University

Search outside SwePub

Extend your search to:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se