Tratamiento Quirúrgico y Complicaciones de los Pacientes con Hernias Inguinales Incarceradas en el Hospital Nacional Cayetano Heredia

Abstract

Objectives: To describe clinical and demographic characteristics of patients with incarcerated inguinal hernias at the Cayetano Heredia National Hospital, surgical procedures and associated complications. Materials and Methods: This is a descriptive and retrospective study, a case series design, using as data source medical records, being the basic tool operative reports from cases diagnosed with incarcerated inguinal hernia between 2009 and 2011. Other types of abdominal hernias were excluded from the study. Results: From January 2009 to December 2011, 29 patients were found to have a postoperative diagnosis of incarcerated inguinal hernia, with similar distribution between men and women. The most common type was indirect inguinal hernia and the age of highest incidence was in the range of 45- 54 years. Statistical association was found between admission to operating room > 6 hours from arrival to Emergency and intestinal resection (p <.01). The most common type of approach in these patients was laparotomy with only two cases of laparoscopic surgery. As part of the analysis cases were divided into two groups, group I those who had surgical resection of a bowel segment and group II those without bowel resection. Mesh placement in group I was a risk factor for postoperative complications (p <.01). The most common complication was surgical site infection. Conclusions: There still are controversies in the management of incarcerated and strangulated inguinal hernia, diversity of surgical options exist. Placing mesh in patients with intestinal resection is not a widely accepted procedure.