ABSTRACT
<p><b>OBJECTIVE</b>To investigate the high-risk factors for neonatal incarcerated hernia with intestinal necrosis by logistic regression analysis.</p><p><b>METHODS</b>Retrospective analysis was performed on the clinical data of 131 neonates with incarcerated oblique inguinal hernia containing the intestine. Of the 131 cases, 14 suffered from intestinal necrosis. The high risk factors for neonatal incarcerated hernia with intestinal necrosis were determined by logistic regression analysis.</p><p><b>RESULTS</b>Manual reduction after incarceration (>2 times) (χ2 = 69.289, P<0.01), incarceration history (>2 times) (χ2 = 84.731, P<0.01), and mesentery incarceration (χ2 = 80.233, P<0.01) were the high-risk factors for neonatal incarcerated hernia with intestinal necrosis.</p><p><b>CONCLUSIONS</b>Intestinal necrosis tends to occur in neonates with incarcerated hernia who have incarceration or received manual reduction more than twice and suffer from mesentery incarceration. Manual reduction is prohibited for these cases, which should be surgically treated immediately.</p>
Subject(s)
Female , Humans , Infant, Newborn , Male , Hernia, Inguinal , Intestines , Pathology , Logistic Models , Necrosis , Retrospective Studies , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical application of transumbilical double-hole laparoscopic operation for incarcerated inguinal hernia in the infants.</p><p><b>METHODS</b>Forty-eight cases with incarcerated inguinal hernia (male 39, female 9) aging from 4 months to 3 years (mean 1.2 +/- 0.8 years) received the laparoscopic transumbilical double-hole operation (LTO group) during April.2003 to April.2004. Thirty cases were left side incarcerated inguinal hernia, 12 cases were right side and 6 cases were bilateral. Fifty infants of incarcerated inguinal hernias treated with traditional operation served as controls (TO group). The mean operation time, length of stay, return of bowel function and postoperative complication were compared between the two groups.</p><p><b>RESULTS</b>All cases of both groups recovered without any complication. The operation time, average hospitalization and return of bowel function in LTO were (30 +/- 5) min, (7.8 +/- 0.3) h and (4.4 +/- 0.3) d, respectively, and in TO were (43 +/- 6) min, (23.3 +/- 2.4) h and (6.7 +/- 0.4) d, respectively. There was a significant difference in the two groups (P < 0.05). The patients in both groups were followed up for 3 months to one year. LTO group had no recurrence or atrophy of testis and TO group had one relapse of hernia.</p><p><b>CONCLUSIONS</b>Transumbilical double-hole laparoscopic operation is safe and microinvasive. It is a useful microinvasive procedure in the treatment of incarcerated inguinal hernia for infant.</p>