目的:我们旨在描述患者特征,手术细节,术后结果,闭孔疝的患病率和发病率。闭孔疝罕见,死亡率高,对最佳手术方法尚无共识。鉴于它们的稀有性,缺乏大量数据,尤其是与术后结果有关。
方法:该研究基于全国丹麦疝数据库的数据。包括1998-2023年在丹麦接受闭孔疝手术的所有成年人。主要结果是人口统计学特征,手术细节,术后结果,以及闭孔疝的患病率和发病率。
结果:我们纳入了167例患者(88%为女性)的184例闭孔疝,中位年龄为77岁。急诊手术占修复的42%,72%为腹腔镜。77%的维修使用了网格,缝合线专门用于紧急维修。在57%的病例中发现并发腹股沟疝。急诊手术30天死亡率为14%,21%的再入院率,中位住院时间为6天。选择性手术30天死亡率为0%,10%的再入院率,中位住院时间为0天。疝手术中闭孔疝的患病率为0.084%(95%CI:0.071%-0.098%),每年每40万居民中就有一人。
结论:这是迄今为止针对闭孔疝的最大的队列研究。它们很罕见,主要是老年妇女。修复的方法取决于表现是否急性,紧急修复与较高的死亡率相关。
OBJECTIVE: We aimed describe the patient characteristics, surgical details, postoperative outcomes, and prevalence and incidence of obturator hernias. Obturator hernias are rare with high mortality and no consensus on the best surgical approach. Given their rarity, substantial data is lacking, especially related to postoperative outcomes.
METHODS: The study was based on data from the nationwide Danish Hernia Database. All adults who underwent obturator hernia surgery in Denmark during 1998-2023 were included. The primary outcomes were demographic characteristics, surgical details, postoperative outcomes, and the prevalence and incidence of obturator hernias.
RESULTS: We included 184 obturator hernias in 167 patients (88% females) with a median age of 77 years. Emergency surgeries constituted 42% of repairs, and 72% were laparoscopic. Mesh was used in 77% of the repairs, with sutures exclusively used in emergency repairs. Concurrent groin hernias were found in 57% of cases. Emergency surgeries had a 30-day mortality of 14%, readmission rate of 21%, and median length of stay of 6 days. Elective surgeries had a 30-day mortality of 0%, readmission rate of 10%, and median length of stay of 0 days. The prevalence of obturator hernias in hernia surgery was 0.084% (95% CI: 0.071%-0.098%), with an incidence of one per 400,000 inhabitants annually.
CONCLUSIONS: This was the largest cohort study to date on obturator hernias. They were rare, affected primarily elderly women. The method of repair depends on whether the presentation is acute, and emergency repair is associated with higher mortality.