Factors Affecting Morbidity, Mortality, and Recurrence in Incarcerated Femoral Hernia

Abstract

Objective: To ascertain the factors that govern morbidity, mortality, and recurrence in incarcerated femoral hernia. Study Design: Observational study. Place and Duration of Study: Department of General Surgery, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey, between January 2010 and January 2020. Methodology: This observational study included patients operated on due to incarcerated femoral hernias under emergency conditions. The preoperative, intraoperative, and postoperative parameters of the patients were gathered. The study excluded pregnant patients and patients in the pediatric age group (0-18 years). Mann-Whitney U-test was used to compare quantitative variables. In addition, a Chi-square test and Likelihood-ratio test were used to compare the qualitative variables. A p-value <0.05 was deemed statistically significant. Results: The mean age of the 50 patients was 54.56 +/- 19.34 (19-91) years and the female/male ratio was 33:17. The morbidity, mortality, and recurrence rates of the study were 14%, 4%, and 6% respectively. Higher morbidity was observed in patients who had preoperative nausea (p = 0.003), vomiting (p <0.001), tachycardia (p <0.001), recurrent hernia (p <0.001), surgery under general anesthesia (p <0.001) or who underwent both laparotomy (p = 0.007) and visceral resection during surgery (p <0.001). Higher rates of mortality were observed in patients who had preoperative tachycardia (p = 0.054) or visceral resection during surgery (p = 0.029). However, the study identified no factors affecting recurrence. Conclusion: In cases of incarcerated femoral hernia, symptoms of intestinal obstruction or signs of strangulation are more important in the development of postoperative morbidity. In addition, the probability of mortality is higher in patients who had preoperative tachycardia and in patients who underwent visceral resection. To the extent possible, regional anesthesia should be preferred in suitable cases.