Risk factors for bowel resection and postoperative complications in incarcerated abdominal wall hernia

嵌顿性腹壁疝肠切除术及术后并发症的危险因素

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Abstract

OBJECTIVE: Timely identification of the risk of bowel resection is crucial for improving surgical outcomes in incarcerated hernias. Preoperative recognition of risk factors can improve postoperative recovery and patient safety. This study aims to investigate the predictors of bowel resection and postoperative complications in patients undergoing surgery for incarcerated abdominal wall hernias. MATERIAL AND METHODS: A single-center retrospective analysis was performed on patients who underwent surgery for incarcerated abdominal wall hernia between January 2017 and January 2022. Multivariate logistic regression was performed to determine risk factors for bowel resection, postoperative complications, and mortality. A p-value of <0.05 was considered statistically significant. RESULTS: A total of ninety-two patients were detected. Mean age was 66.1±14.5 years and the 76 (82.6%) of the patients were male. Bowel resection was associated with symptom duration, higher platelet count, higher neutrophil to lymphocyte and platelet to lymphocyte ratio (p=0.014, p=0.040, p=0.042, p=0.015). Postoperative hospital stay was longer and postoperative mortality was higher in patients who underwent bowel resection (p<0.001, p=0.013). No risk factors for bowel resection or mortality were identified. Symptom duration and bowel resection were found to be risk factors for postoperative complications [odds ratio (OR): 1.713, 95% confidence interval (CI): 1.093-2.686; p=0.019] (OR: 4.655, 95% CI: 1.230-17.613; p=0.023). CONCLUSION: Although no specific risk factors for bowel resection or mortality have been identified, symptom duration and bowel resection may be considered risk factors for postoperative complications in these patients. Furthermore, hernia sac fluid is not a risk factor for bowel resection.

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