ABSTRACT
Introducción. La hernia de Amyand es una condición en la que el apéndice cecal está contenido dentro del saco herniario inguinal. Su diagnóstico y su manejo continúan siendo un reto al tratarse de una patología poco frecuente. Caso clínico. Lactante varón de 10 meses con antecedente de prematuridad extrema, quien presentó hernia de Amyand derecha con apéndice normal. Se retornó el apéndice a la cavidad y se procedió a la reparación de la hernia. Resultado. Después de un año de seguimiento, el paciente no presentó complicaciones. Conclusiones. Se ha reportado que el riesgo de incarceración en niños nacidos a término es del 12 % y en prematuros del 39 %, por tanto, la reparación quirúrgica de una hernia inguinal siempre es necesaria. No existe un tratamiento estándar para la hernia de Amyand en niños, por tanto, la clasificación CiX podría considerarse para el manejo. Se presenta una propuesta de tratamiento en la población pediátrica, donde se incluyeron 3 tipos, considerando el estadio evolutivo del apéndice cecal y que casi la totalidad de hernias inguinales en niños son debidas a persistencia del proceso vaginal, por tanto, el tratamiento quirúrgico solo incluye herniotomía. Al no utilizar material protésico, se facilita el manejo y se reduce el riesgo de infección.
Introduction. Amyand's hernia is a condition in which the cecal appendix is contained within the inguinal hernia sac, its diagnosis and management continue to be a challenge as it is a rare pathology. Case report. A 10-month-old male infant with a history of extreme prematurity presented a right Amyand's hernia and a normal appendix. The appendix was returned to the cavity and the hernia was repaired. Result. After one year of follow-up, the patient had no complications. Conclusions. Has been reported that the risk of incarceration in full-term children is 12% and in premature babies it is 39%, therefore, surgical repair of an inguinal hernia is always necessary. There is no standard treatment for Amyand hernia in children, therefore the CiX classification could be considered for management. A treatment proposal is presented in the pediatric population, where three types were included, considering the evolutionary stage of the cecal appendix and that almost all inguinal hernias in children are due to persistence of the vaginal process; therefore, surgical treatment only includes herniotomy. By not using prosthetic material, handling is facilitated and the risk of infection is reduced.
Subject(s)
Humans , Appendicitis , Infant, Premature , Hernia, Inguinal , Appendix , Hernia , InfantABSTRACT
Introducción. Los pacientes octogenarios y nonagenarios conforman un grupo etario en progresivo crecimiento. La hernia inguinal es una patología que aumenta progresivamente con la edad. Este trabajo tuvo como objetivo conocer los resultados quirúrgicos de los pacientes mayores de 80 años a quienes se les realizó herniorrafía inguinal. Métodos. De acuerdo con las guías PRISMA, se realizó una revisión sistemática de PubMed, Embase y Google Scholar. Se incluyeron estudios que reportaron la incidencia de complicaciones y mortalidad después de una herniorrafía inguinal en los pacientes octogenarios y nonagenarios. Se calculó la proporción de pacientes con complicaciones después de una herniorrafía inguinal según los datos presentados, con su respectivo intervalo de confianza del 95 %. Resultados. Catorce estudios reportaron un total de 19.290 pacientes, entre quienes se encontró una incidencia acumulada de infección del sitio operatorio de 0,5 % (IC95% 0,460 - 0,678), seroma de 8,7 % (IC95% 6,212 - 11,842), hematoma de 2,6 % (IC95% 2,397 - 2,893), dolor crónico de 2,1 % (IC95% 0,778 - 4,090) y recidiva de 1,2 % (IC95%0,425 - 2,284), para una morbilidad de 14,7 % (IC95% 9,525 - 20,833). Conclusión. Las complicaciones de la herida quirúrgica, el dolor crónico y la recidiva en los pacientes mayores de 80 años a quienes se les realiza herniorrafia inguinal son comparables con las de la población general.
Introduction. Octogenarian and nonagenarian patients constitute a progressively growing age group. Inguinal hernia is a pathology that increases with age. This study aims to understand the surgical outcomes of inguinal herniorrhaphy in patients over 80 years of age. Methods. A systematic review of PubMed, Embase, and Google Scholar was conducted following PRISMA guidelines. Studies reporting the incidence of complications and mortality after inguinal herniorrhaphy in octogenarian and nonagenarian patients were included. The proportion of patients with complications after inguinal herniorrhaphy was calculated based on the data presented, with its respective 95% confidence interval. Results. Fourteen studies reported a total of 19,290 patients, among whom a cumulative incidence of surgical site infection of 0.5 (95% CI 0.460 0.678), seroma of 8.7% (95% CI 6.212 11.842), hematoma of 2.6% (95% CI 2.397 2.893), chronic pain 2.1% (95% CI 0.778 4.090), recurrence 1.2% (95% CI 0.425 2.284), and morbidity 14.7% (95% CI 9.525 20.833) were found. Conclusion. Surgical wound complications, chronic pain, and recurrence in patients over 80 years of age undergoing inguinal herniorrhaphy are comparable to those in the general population.
Subject(s)
Humans , Herniorrhaphy , Hernia, Inguinal , Postoperative Complications , Recurrence , Aged, 80 and over , Meta-AnalysisABSTRACT
Introducción. Las hernias gigantes con pérdida de domicilio son aquellas cuyo saco herniario alcanza el punto medio del muslo en bipedestación y su contenido excede el volumen de la cavidad abdominal. Estas hernias son un reto quirúrgico dada la difícil reducción de su contenido y del cierre primario de la fascia. Tienen mayor riesgo de complicaciones asociadas al síndrome compartimental abdominal, así como mayor tasa de recurrencia y morbilidad en los pacientes. Caso clínico. Paciente masculino de 81 años, reconsultante por hernia inguinoescrotal derecha gigante, de dos años de evolución, sintomática, con índice de Tanaka de 24 %. Se decidió aplicar el protocolo de neumoperitoneo secuencial (hasta 11.000 ml en total en cavidad) además de toxina botulínica en pared abdominal (dos sesiones). Resultados. Se logró la corrección exitosa de la hernia inguinoescrotal gigante, sin recaídas de su patología abdomino-inguinal. El paciente manifestó satisfacción con el tratamiento un año después del procedimiento. Conclusiones. El protocolo de neumoperitoneo secuencial es una alternativa en casos de hernias complejas, con alto riesgo de complicaciones, que requieren técnicas reconstructivas adicionales. La aplicación previa de toxina botulínica es un adyuvante considerable para aumentar la probabilidad de resultados favorables. Sin embargo, debe incentivarse la investigación en esta área para evaluar su efectividad.
Introduction. Giant hernias with loss of domain are those whose hernial sac reaches the midpoint of the thigh in standing position and whose content exceeds the volume of the abdominal cavity. These hernias are a surgical challenge given the difficult reduction of their contents and the primary fascial closure, with a higher risk of complications associated with abdominal compartment syndrome, as well as a higher rate of recurrence and morbidity in patients. Clinical case. A 81-year-old male patient with comorbidity, reconsulting due to a symptomatic giant right inguinoscrotal hernia of two years of evolution, with a Tanaka index of 24%, eligible for a sequential pneumoperitoneum protocol (up to a total of 11,000 cc in cavity) plus application of botulinum toxin (two sessions) in the abdominal wall. Results. Successful correction of the patient's giant inguinoscrotal hernia was achieved using this protocol, without recurrence of his abdomino-inguinal pathology and satisfaction with the procedure after one year. Conclusion. The sequential pneumoperitoneum protocol continues to be an important alternative in cases with a high risk of complications that require additional reconstructive techniques, while the previous application of botulinum toxin is a considerable adjuvant to further increase the rate of favorable results. However, research in the area should be encouraged to reaffirm its effectiveness.
Subject(s)
Humans , Pneumoperitoneum, Artificial , Botulinum Toxins, Type A , Hernia, Inguinal , Prostheses and Implants , Hernia, Abdominal , HerniorrhaphyABSTRACT
Objective:To investigate the analgesic effect of ultrasound-guided transversus abdominis plane block versus ultrasound-guided quadratus lumborum block in older adult patients undergoing inguinal hernia repair surgery. Methods:A total of 150 older adult patients who underwent inguinal hernia repair surgery at the Marine Police Corps Hospital of Chinese People's Armed Police Force from April 2019 to May 2022 were included in this study. They were randomly divided into a control group ( n = 75) and a study group ( n = 75) using a random number table method. All patients underwent elective laparoscopic tension-free inguinal hernia repair surgery. Patients in the control group received ultrasound-guided transversus abdominis plane block after inguinal hernia repair surgery, while those in the study group received ultrasound-guided quadratus lumborum block. The changes in Visual Analog Scale (VAS) score and Ramsay score within 48 hours after surgery were compared between the two groups. Inflammatory factors and stress factors including serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol, were measured at 24 and 48 hours after surgery. The use of analgesics, drug-related adverse reactions, and incidence of nerve block-related complications within 48 hours after surgery were also compared between the two groups. Results:There was no significant difference in Ramsay score between the two groups at 4, 8, 12, 24, and 48 hours after surgery (all P > 0.05). There was no significant difference in VAS score between the two groups at 4 and 8 hours after surgery (both P > 0.05). At 12, 24, and 48 hours after surgery, the VAS score in the study group was (1.36 ± 0.57) points, (2.05 ± 0.56) points, and (1.79 ± 0.55) points, respectively, which were significantly lower than (1.92 ± 0.59) points, (2.68 ± 0.62) points, and (2.36 ± 0.59) points in the control group ( t = 6.65, 7.31, 5.86, all P < 0.001). At 24 and 48 hours after surgery, serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol levels in the study group [24 hours: (63.89 ± 4.65) ng/L, (156.59 ± 8.62) ng/L, (97.02 ± 6.95) g/L, (36.95 ± 3.26) g/L; 48 hours: (49.66 ± 3.74) ng/L, (131.45 ± 7.73) ng/L, (74.63 ± 5.91) g/L, (30.41 ± 2.96) g/L] were significantly lower than those in the control group [24 hours: (76.42 ± 5.17) ng/L, (189.32 ± 10.41) ng/L, (105.53 ± 7.83) g/L, (45.16 ± 3.74) g/L; 48 hours: (58.15 ± 3.94) ng/L, (162.74 ± 8.49) ng/L, (89.51 ± 6.37) g/L, (36.92 ± 3.31) g/L, t = 10.49-26.38, all P < 0.001]. The proportion of patients who received analgesics within 48 hours after surgery in the study group was 8.00% (6/75), which was significantly lower than 25.33% (19/75) in the control group ( χ2 = 8.11, P = 0.004). The overall incidence of drug-related adverse reactions within 48 hours after surgery in the study group [6.67% (3/75)] was significantly lower than that in the control group [11% (11/75), χ2 = 4.61, P = 0.032]. Conclusion:Compared with ultrasound-guided transversus abdominis plane block, ultrasound-guided quadratus lumborum block better helps alleviate postoperative pain in older adult patients undergoing inguinal hernia repair surgery, inhibits inflammation and stress reactions, reduces the dosage of analgesic drugs, and decreases the incidence of adverse drug reactions.
ABSTRACT
ABSTRACT BACKGROUND: Results on quality of life after inguinal hernia surgery, such as esthetics, postoperative pain, period of absence from activities, and recurrence are a relevant topic since inguinal hernia affects 27% of men and 3% of women at some point in their lives, and should guide health policies to allocate resources more efficiently. AIMS: To evaluate the quality of life in the late postoperative period of inguinal herniorrhaphy regarding recurrence, pain, esthetics, and restriction in activities, comparing the minimally invasive techniques — the transabdominal preperitoneal (TAPP) and the conventional Lichtenstein. METHODS: A cross-sectional observational clinical study was conducted with the EuraHS-QoL questionnaire validated and translated into Portuguese, applied to patients after an average of 65 months postoperatively. Forty-five patients were assessed, 28 undergoing Lichtenstein and 17 undergoing TAPP. All were males aged between 18 and 87 years with a primary unilateral inguinal hernia. Recurrent or bilateral hernias, other concomitant abdominal wall hernias, patients who chose not to participate or who were not found, and female patients were excluded from the study. RESULTS: Regarding the domains pain, restriction, and esthetics, there was no difference between the two groups when examining quality of life. Neither group presented recurrence in the studied period. CONCLUSIONS: Both TAPP and Lichtenstein techniques presented similar results concerning quality of life when compared in the long-term.
RESUMO RACIONAL: Os resultados de qualidade de vida após cirurgia de hérnia inguinal, como estética, dor pós-operatória, período de afastamento das atividades e recorrência é um tema relevante, uma vez que a hérnia inguinal atinge 27% dos homens e 3% das mulheres em algum momento da vida, e deveriam orientar as políticas de saúde para alocar recursos de forma mais eficiente. OBJETIVOS: Avaliar a qualidade de vida no pós-operatório tardio de herniorrafia inguinal quanto a recidiva, dor, estética e restrição de atividades, comparando as técnicas minimamente invasivas transabdominal pré-peritoneal (TAPP) e convencional, Lichtenstein. MÉTODOS: Estudo clínico observacional transversal com questionário EuraHS-QoL validado e traduzido para o português, aplicado em pacientes após média de 65 meses de pós-operatório. Foram estudados 45 pacientes, 28 submetidos a Lichtenstein e 17 submetidos a TAPP. Todos eram do sexo masculino, com idade entre 18 e 87 anos, com hérnia inguinal unilateral primária. Hérnias recorrentes ou bilaterais, outras hérnias concomitantes da parede abdominal, pacientes que optaram por não participar ou que não foram encontrados e pacientes do sexo feminino foram excluídos do estudo. RESULTADOS: Em relação aos domínios dor, restrição e cosméticos, não houve diferença entre os dois grupos na avaliação da qualidade de vida. Os dois grupos não apresentaram recidiva no período estudado. CONCLUSÕES: Tanto a técnica TAPP quanto a técnica de Lichtenstein, neste estudo, apresentaram resultados semelhantes, quando comparadas em longo prazo, no que diz respeito à qualidade de vida
ABSTRACT
Las hernias gigantes de Amyand son hernias inguinales excepcionales por extenderse por debajo de la mitad del muslo en posición de pie y contener al apéndice cecal. Presentamos un paciente portador de una hernia gigante de Amyand irreductible, al cual se le realiza una reparación quirúrgicas, mediante una combinada de técnicas para su resolución. El tratamiento de las hernias inguinales gigantes es todo un desafío, debido a la distorsión anatomía existente, y por la pérdida de derecho a domicilio de los órganos que puede llegar a ocasionar. Consideramos que la combinación de las técnicas de Bassini y Lichtennstein asociado a las maniobras de Ombrédanne y de Camay es una estrategia adecuada para reparar exitosamente las hernias inguinales gigantes grado I. La apendicectomía en la hernia de Amyand tipo I es una alternativa de tratamiento cuando existe riesgo de apendicitis aguda.
Giant Amyand hernias are exceptional inguinal hernias because they extend below the middle of the thigh in the standing position and contain the cecal appendix. We present a patient with an irreducible giant Amyand hernia, who underwent surgical repair, using a combination of techniques for its resolution. The treatment of giant inguinal hernias is quite a challenge, due to the existing anatomical distortion, and the loss of the right to domicile of the organs that it can cause. We consider that the combination of the Bassini and Lichtenstein techniques associated with the Ombrédanne and Camay maneuvers is an appropriate strategy to successfully repair grade I giant inguinal hernias. Appendectomy in Amyand type I hernia is a treatment alternative when a risk of acute appendicitis exists.
ABSTRACT
La hernia inguinal supone la patología de pared abdominal más frecuente hoy en día. En el saco herniario podemos encontrar diferentes estructuras, como grasa preperitoneal, intestino delgado, colon o incluso la vejiga, resultando inusual la presencia de la trompa de Falopio y el ovario. El contenido tubo-ovárico supone un hallazgo frecuente en población pediátrica, mientras que resulta un hecho extremadamente raro en mujeres en edad reproductiva o menopáusica, siendo imprescindible su tratamiento con el fin de evitar complicaciones relacionadas con la fertilidad y la viabilidad de los anejos. Con el objetivo de revisar la bibliografía descrita al respecto dado la infrecuencia que supone este hallazgo en mujeres adultas, se presenta el siguiente caso clínico de forma resumida, con la consiguiente revisión de la literatura disponible. Se trata de una paciente mujer de 50 años, con antecedentes de mioma uterino, intervenida de forma programada de hernioplastia inguinal derecha, observando contenido tubo-ovárico en el saco herniario, en la cual se realiza hernioplastia inguinal según la técnica de Lichtenstein con preservación de anejos sin complicaciones postoperatorias. Como conclusiones finales, consideramos que los hallazgos intraoperatorios de contenido tubo-ovárico en la cirugía de hernia inguinal en mujeres adultas supone un hecho infrecuente, cuyo conocimiento y manejo resulta necesario para el cirujano general, precisando de un índice de alta sospecha con el fin de evitar complicaciones y otorgar el tratamiento quirúrgico más óptimo para el bienestar de los pacientes.
Inguinal hernia represents the most common pathology of the abdominal wall currently. In the hernia sac, various structures can be found, such as preperitonealphat, smallbowel, colon, oreventhe bladder, but the presence of the fall opiantube and ovaryisun common. Tubo-ovarian content is a frequent finding in pediatric population, while infection is extremely rare in women of reproductive or menopausal age, requiring essential treatment to prevent complications related to fertility and adnexal viability. In order to review the literature described in this regard, given the infrequency of this finding in adult women, we present the following clinical case, along with a review of the available literature. The patient is a 50-year-old woman with a history of uterine fibroids, who underwent surgery of a right inguinal hernioplasty, revealing tube-ovarian content in the hernia sac. Inguinal hernioplasty was performed using the Lichtenstein technique with preservation of adnexa, and there were no postoperative complications. In final conclusions, we consider that intraoperative finding of tube-ovarian content in inguinal hernia surgery in adult women are uncommon, and knowledge and management of this condition are necessary for the general surgeon. A high index of suspicion is required to avoid complications and provide the most optimal surgical treatment for the well-being of patients.
A hérnia inguinal representa uma patologia comum da parede abdominal nos dias seguintes. No saco herniário, podem ser encontradas diferentes estruturas, como gordura pré-peritoneal, intestino delgado, cólon propriamente dito com a bexiga, sendoincomum com presença da trompa de Falópio e do ovário. O conteúdo trompa-ovariano é muito comum em populações pediátricas, mas é extremamente raro em mulheres em saúde reprodutiva ou na menopausa, sendo essencial ou seutratamento para evitar complicações relacionadas à fertilidade e à viabilidade dos dois anexos. Com o objetivo de revisar a bibliografia descrita a esse respeito, dado pouco discutido em mulheres adultas, o seguinte caso clínico é apresentado de forma resumida, juntamente com uma revisão da literatura disponível. Trata-se de paciente do sexo feminino, 50 anos, com história de mioma uterino, submetida a hernioplastia inguinal direta programada, observando-se conteúdo da tuba ovariana e saco herniário. A hernioplastia inguinal foi realizada segundo a técnica de Lichtenstein, comprimindo dois anexos e sem complicações operatórias. Como conclusões finais, consideramos que a redução intraoperatória do conteúdo tubo-ovariano na cirurgia de hérnia inguinal em mulheres adultas é incomum, e o conhecimento e o manejo dos procedimentos necessários à cirurgia geral requerem um alto índice de suspeita para evitar complicações e proporcionar tratamento cirúrgico . maisadequado para ou bem-est dois pacientes.
Subject(s)
Humans , Female , Middle Aged , Ovary/surgery , Fallopian Tubes/surgery , Hernia, Inguinal/surgery , Hernia, Inguinal/complications , Ovary/pathology , Perimenopause , Fallopian Tubes/pathology , HerniorrhaphyABSTRACT
La hernia inguinal es uno de los problemas urgentes más comunes encontrados por los cirujanos. Hubo 145 pacientes tratados debido al diagnóstico de hernia inguinal. De 44 pacientes que fueron operados en condiciones de emergencia. Alrededor de 131 casos (106 hombres y 25 mujeres) fueron tratados con reparación de malla preperitoneal abierta unilateral. Los pacientes fueron examinados en términos de complicaciones postoperatorias. Los datos recopilados incluidos como edad, sexo, historial médico, afecciones de cirugía, encarcelamiento y estrangulamiento. Hubo un total de 145 pacientes incluidos en el estudio; en el que 44 de ellos (29 hombres y 15 mujeres, rango de edad: 30-72) (Grupo I) fueron operados en condiciones de emergencia y 101 de ellas (51 hombres y 50 mujeres, rango de edad: 25-78) (grupo Ii) fueron operados en condiciones electivas. Hubo comorbilidad en 31 pacientes de grupo I y 77 pacientes del grupo II. Alrededor del 47.7% (n = 21) de los casos que se sometieron a cirugía emergente debido al encarcelamiento, mientras que el 43.6% (n = 44) de los casos que fueron operados en condiciones electivas. Había 12 hernias femorales en el Grupo I y 19 Hernia femoral en el Grupo II. No hay diferencia entre la complicación postoperatoria y las tasas de recurrencia en los casos de hernia inguinal operados en condiciones electivas y en condiciones de emergencia. Es más barato que la reparación laparoscópica, el control del dolor de plomo y la falta de dolor neuropático, tiene complicaciones menos testiculares, y es más ventajoso que otros enfoques abiertos
Inguinal hernia is one of the most common urgent problems encountered by surgeons. There were 145 patients treated due to inguinal hernia diagnosis. Out of 44 patients who were operated under emergency conditions. About 131 cases (106 male and 25 female) were treated with unilateral open preperitoneal mesh repair. Patients were examined in terms of postoperative complications. Data collected included as age, gender, medical history, surgery conditions, incarceration and strangulation. There were total of 145 patients included in the study; in which 44 of them (29 male and 15 female, range of age: 30- 72) (group I) were operated under emergency conditions and 101 of them (51 male and 50 female, range of age: 25-78) (group II) were operated under elective conditions. There was comorbidity in 31 patients of group I and 77 patients of group II. About 47.7% (n=21) of cases who underwent emergent surgery due to incarceration, while 43.6% (n=44) of cases who were operated under elective conditions. There were 12 femoral hernias in group I and 19 femoral hernia in group II. There is no difference between postoperative complication and recurrence rates in inguinal hernia cases operated under elective conditions and under emergency conditions. It is cheaper than laparoscopic repair, lead pain control and lack of neuropathic pain, has less testicular complications, and it is more advantageous than other open approaches.
Subject(s)
Humans , Male , Female , Laparoscopy , Herniorrhaphy/methods , Hernia, Femoral/surgery , Hernia, Inguinal/surgeryABSTRACT
Introducción: la hernia inguinal es uno de los principales motivos de consulta quirúrgica y su reparación es uno de los procedimientos más comunes en cirugía. Objetivo: determinar la experiencia en el abordaje laparoscópico de las hernias inguinales por técnica transabdominal preperitoneal en el Servicio de Cirugía General del Centro Médico Nacional-Hospital Nacional. Metodología: estudio observacional descriptivo retrospectivo de corte temporal transversal. En pacientes de 16 a 90 años de edad con diagnóstico de hernia inguinal internados en el Servicio de Cirugía General del Centro Médico Nacional-Hospital Nacional para hernioplastia electiva. Resultados: se llevaron a cabo 30 hernioplastias por técnica técnica trans-abdominal pre-peritoneal de los cuales el 73 % fue realizado en hombres y 27 % en mujeres; se identificó una media de edad de 48,4 años, el grupo etario con mayor frecuencia fue de 38 a 48 años. En el examen físico pre quirúrgico se encontraron hernias inguinales unilaterales en el 76.6 % y bilaterales en el 23.3 %; en la mayor parte de los pacientes las hernias fueron primarias en el 86.6 %y recidivada en el 13.3 %. El tiempo quirúrgico en promedio fue de 93.1 minutos; con un tiempo máximo de 120 minutos y mínimo de 60 minutos. El tiempo de hospitalización en el 100 % de los pacientes fue de 48 h. De las complicaciones post operatorias se establece que el 76.6 % no presento ningún tipo de complicación; el 20 % presentó seroma como complicación principal y 3.3 % infección del sitio quirúrgico. Conclusión: debido a su alta frecuencia y a su impacto en la incapacidad laboral y social, las hernias inguinales representan una de las patologías quirúrgicas más importantes con bajas tasas de complicaciones post operatorias y corta estancia hospitalaria.
Introduction: inguinal hernia is one of the main reasons TAPP, e-TEP (Totally extraperitoneal with extended vision) for surgical consultation and its repair is one of the most common surgical procedures. Objective: to determine the experience in the laparoscopic approach of inguinal hernias by preperitoneal transabdominal technique in the Servicio de Cirugía General of the Centro Médico Nacional-Hospital Nacional. Methodology: retrospective descriptive observational study of cross-sectional time. In patients from 16 to 90 years of age with a diagnosis of inguinal hernia admitted to the Servicio de Cirugía General of the Centro Médico Nacional-Hospital Nacional for elective hernioplasty. Results: 30 hernioplasties were carried out by the TAPP technique, of which 73 % were performed in men and 27 % in women; a mean age of 48.4 years was identified, the age group most frequently being 38 to 48 years. In the pre-surgical physical examination, unilateral inguinal hernias were found in 76.6 % and bilateral in 23.3 %; in most of the patients the hernias were primary in 86.6 % and recurred in 13.3 %. Average surgical time was 93.1 minutes; with a maximum time of 120 minutes and a minimum of 60 minutes. The hospitalization time in 100 % of the patients was 48 hours. Of the post-operative complications, it is established that 76.6% did not present any type of complication; 20 % presented seroma as the main complication and 3.3 % surgical site infection. Conclusion: due to its high frequency and its impact on work and social disability, inguinal hernias represent one of the most important surgical pathologies with low rates of postoperative complications and short hospital stay.
ABSTRACT
Introducción. El espacio extraperitoneal, se define como el segmento topográfico ubicado entre el peritoneo parietal internamente y la fascia transversalis externamente. Como resultado del desarrollo y consolidación de la cirugía laparoscópica, en particular de la herniorrafia inguinal por esta vía, se ha presentado un renovado y creciente interés en esta área anatómica, debido a la importancia de su conocimiento detallado en la cirugía de mínima invasión. Métodos. Se hizo una revisión narrativa de la literatura para presentar una información actualizada y detallada sobre la anatomía del espacio extraperitoneal y su importancia en diferentes procedimientos quirúrgicos realizados actualmente. Resultados. Por fuera del espacio peritoneal, se encuentran las áreas anatómicas externas al peritoneo parietal, que incluyen la preperitoneal y la retroperitoneal. Mediante la laparoscopia, se pueden localizar en estos espacios cinco triángulos anatómicos, además de la corona mortis y el triángulo supra vesical. Conclusión. El conocimiento del espacio extraperitoneal es de gran importancia para el cirujano general, teniendo en cuenta los múltiples procedimientos que requieren el abordaje de esta área topográfica
Introduction. The extraperitoneal space is defined as the topographic segment located between the parietal peritoneum internally and the fascia transversalis externally. As a result of the development and consolidation of laparoscopic surgery, particularly inguinal herniorrhaphy by this route, there has been a renewed and growing interest in this anatomical area, due to the importance of its detailed knowledge in minimally invasive surgery. Methods. A narrative review of the literature was made to present updated and detailed information on the anatomy of the extraperitoneal space and its importance in different surgical procedures currently performed. Results. Outside the peritoneal space are the anatomical areas external to the parietal peritoneum, including the preperitoneal and extraperitoneal. Using laparoscopy, five anatomical triangles, in addition to the corona mortis and the supravesical triangle, can be located in these spaces. Conclusion. Knowledge of the extraperitoneal space is of great importance for the general surgeon, taking into account the multiple procedures that require the approach of this topographic area
Subject(s)
Humans , Retroperitoneal Space , Hernia, Inguinal , Peritoneal Cavity , Laparoscopy , AnatomyABSTRACT
Las hernias inguinales son una patología para tratamiento quirúrgico frecuente, afecta entre un 3 a 5 % de toda la población en general, su reparación resulta difícil y peligrosa en caso de recurrencia; un paciente sometido a cirugía tiene entre19 39 % de probabilidades de recidiva, y esto aumenta con cada nuevo procedimiento. Objetivo: caracterizar la prevalencia de recidivas de hernias inguinales en pacientes intervenidos quirúrgicamente en el Servicio de Cirugía General del Hospital Universitario de Caracas entre los años 2015-2020. Métodos: estudio retrospectivo, descriptivo y analítico. Resultados: se estudiaron 52 casos de recidivas de hernias inguinales, 43 % de un total de 120 pacientes sometidos a hernioplastia inguinal, las técnicas quirúrgicas con mayor número de recidivas fueron: la de Bassini con 14 %, la de Rutkow-Robbins con 10 % y la de Linchtenstein con 9 % de los casos; con un tiempo de recidiva posterior a la primera intervención el cual fue mayor al año de la primera intervención. Conclusiones: la recidiva resultó un poco mayor al promedio, el tiempo en el cual ocurrió es mayor al año de la intervención y las técnicas más involucradas fueron, enorden decreciente: Bassini, Rutkow-Robbins, y Linchtenstein(AU)
Inguinal hernias are a pathology for frequent surgical treatment, affecting between 3 to 5 % of the entire population in general, their repair is difficult and dangerousin case of recurrence; a patient undergoing surgery has a19-39 % chance of recurrence, and this increases with eachnew procedure. Objective: to characterize the prevalence of recurrences of inguinal hernias in patients undergoing surgery at the General Surgery Service of the Hospital Universitario de Caracas between the years 2015-2020. Methods: retrospective, descriptive and analytical study. Results: 52 cases of inguinalhernia recurrences were studied, 43 % of a total of 120 patients undergoing inguinal hernioplasty, the surgical techniques with the highest number of recurrences were: Bassini with 14 %,that of Rutkow-Robbins with 10 % and that of Linchtensteinwith 9 % of the cases; with a recurrence time after the first intervention which was greater than a year after the first intervention. Conclusions: the recurrence was a little high erthan the average, the time in which it occurred is greater than a year othehe intervention and the techniques most involved were,in decreasing order: Bassini, Rutkow-Robbins, and Lichtenstei(AU)
Subject(s)
Humans , Male , Female , General Surgery , Hernia, Inguinal/pathology , HerniorrhaphyABSTRACT
Las hernias que se ubican en la pared abdominal son consideradas una patología de alta prevalencia en la población mundial, ya que se estima que el 55 % de las personas se ve afectada en algún momento de su vida por esta enfermedad. Además, se someten anualmente más de 20 millones de pacientes a nivel mundial a reparación de hernia inguinal, como gran parte de estos pacientes presentan comorbilidades, es importante conocer las complicaciones que conlleva este procedimiento. Objetivo. Identificar estrategias para reducir la incidencia de complicaciones y mejorar los resultados a largo plazo de la hernioplastia inguinal laparoscópica. Metodología. Se realizó una revisión sistemática, de estudios observacionales, donde las principales bases de datos utilizados fueron PubMed y Google Scholar cuyos descriptores DeCS-MeSH se presentan con el siguiente algoritmo de búsqueda "Complications" AND "laparoscopic" AND "inguinal" AND "hernioplasty". Se incluyeron los trabajos relacionados con el tema de investigación, publicados en español o inglés en periodos más recientes o publicados dentro de los últimos 5 años. Conclusión. La incidencia de hernias inguinales aumenta con la edad, especialmente entre la quinta y la séptima década de la vida por lo cual conlleva a complicaciones que van desde morbilidad de la herida, recurrencia de la hernia, dolor crónico y problemas relacionados con la malla. A pesar de las complicaciones que presenta la reparación de hernia inguinal vía laparoscópica es una de las técnicas más usada actualmente y que brinda una recuperación más rápida.
Hernias located in the abdominal wall are considered a highly prevalent pathology in the world population, since it is estimated that 55% of people are affected at some point in their lives by this disease. In addition, more than 20 million patients worldwide undergo inguinal hernia repair every year. Since most of these patient's present comorbidities, it is important to know the complications that this procedure entails. Objective. To identify strategies to reduce the incidence of complications and improve long-term outcomes of laparoscopic inguinal hernioplasty. Methodology. A systematic review of observational studies was performed, where the main databases used were PubMed and Google Scholar whose DeCS-MeSH descriptors are presented with the following search algorithm "Complications" AND "laparoscopic" AND "inguinal" AND "hernioplasty". Papers related to the research topic, published in Spanish or English in more recent periods or published within the last 5 years, were included. Conclusion. The incidence of inguinal hernias increases with age, especially between the fifth and seventh decade of life, which leads to complications ranging from wound morbidity, hernia recurrence, chronic pain and mesh-related problems. In spite of the complications, laparoscopic inguinal hernia repair is one of the most widely used techniques today and provides a faster recovery.
As hérnias localizadas na parede abdominal são consideradas uma patologia altamente prevalente na população mundial, pois estima-se que 55% das pessoas sejam afetadas em algum momento de suas vidas por essa doença. Além disso, mais de 20 milhões de pacientes em todo o mundo são submetidos a reparos de hérnia inguinal todos os anos. Como muitos desses pacientes têm comorbidades, é importante estar ciente das complicações associadas a esse procedimento. Objetivo. Identificar estratégias para reduzir a incidência de complicações e melhorar os resultados de longo prazo da hernioplastia inguinal laparoscópica. Metodologia. Foi realizada uma revisão sistemática de estudos observacionais, em que os principais bancos de dados utilizados foram o PubMed e o Google Scholar, cujos descritores DeCS-MeSH são apresentados com o seguinte algoritmo de pesquisa: "Complications" AND "laparoscopic" AND "inguinal" AND "hernioplasty". Foram incluídos artigos relacionados ao tópico da pesquisa, publicados em inglês ou espanhol em períodos mais recentes ou publicados nos últimos 5 anos. Conclusão. A incidência de hérnias inguinais aumenta com a idade, especialmente entre a quinta e a sétima década de vida, levando a complicações que vão desde a morbidade da ferida, recorrência da hérnia, dor crônica e problemas relacionados à malha. Apesar das complicações, a correção laparoscópica da hérnia inguinal é uma das técnicas mais usadas atualmente e proporciona uma recuperação mais rápida.
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Objective:To investigate the effects of laparoscopic total extraperitoneal hernia repair (TEP) on respiratory function and motilin (MOL) in elderly patients with inguinal hernia.Methods:One hundred and twenty elderly patients with inguinal hernia admitted in Chongqing Fengdu People′s Hospital from January 2020 to December 2021 were divided into two groups according to the method of operation, 60 patients who performed laparoscopic preperitoneal hernia repair (TAPP) was enrolled in control group, and 60 patients who performed TEP was enrolled in the study group. The operation index, visual analogue scale (VAS) scores at different time, respiratory function index and gastrin (GAS), MOL levels and postoperative complications were compared between the two groups.Results:Compared with the control group, the operation time in the study group was longer, the recovery time was shorter and the VAS scores were lower on the 1st, 3rd and 7th day after operation: (66.36 ± 10.05) min vs. (53.69 ± 8.59) min, (4.09 ± 0.59) d vs. (5.15 ± 1.06) d, (4.49 ± 1.26) scores vs. (5.46 ± 1.48) scores, (3.65 ± 0.58) scores vs. (4.52 ± 0.95) scores, (2.42 ± 0.41) scores vs. (3.54 ± 0.48) scores, there were statistical differences ( P<0.05). The levels of end-expiratory carbon dioxide pressure (P ETCO 2) and airway pressure (Paw) in the study group at 10, 30 and 90 min postoperatively were higher than those in the control group: (40.66 ± 4.52)mmHg(1 mmHg = 0.133 kPa) vs. (37.48 ± 5.26) mmHg, (19.88 ± 1.63) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (16.59 ± 2.15) cmH 2O; (44.65 ± 4.18) mmHg vs. (41.58 ± 4.58) mmHg, (20.49 ± 1.65) cmH 2O vs. (16.95 ± 2.84) cmH 2O; (50.16 ± 3.54) mmHg vs. (45.59 ± 4.65)mmHg, (21.69 ± 1.78) cmH 2O vs. (17.49 ± 2.15) cmH 2O, there were statistical differences ( P<0.05). The levels of MOL and GAS in the study group at 3 d postoperatively were higher than those in the control group: (396.54 ± 13.58) ng/L vs. (332.52 ± 16.95) ng/L, (118.95 ± 8.95) ng/L vs. (102.58 ± 10.65) ng/L, there were statistical differences ( P<0.05). There was no significant difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Both TEP and TAPP have certain therapeutic effects on the inguinal hernia, but TEP has shorter postoperative recovery time, less pain, less impact on gastrointestinal function, but it will have a certain impact on respiratory function.
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Objective:To explore the application effects of modified laparoscopic total extraperitoneal hernia repair (TEP) and laparoscopic transabdominal preperitoneal hernia repair (TAPP) in inguinal hernia.Methods:One hundred and twenty-five patients with inguinal hernia in Yiwu Central Hospital from February 2017 to December 2019 were selected for retrospective study. They were divided into modified TEP group (63 cases) and TAPP group (62 cases). The modified TEP group was treated with modified TEP, and the TAPP group was treated with TAPP. The perioperative operation related indexes, serum oxidative stress indexes, 1-year recurrence rate and semen quality indexes were compared between the two groups.Results:The scores of visual analogue scale after operation for 24 h in the modified TEP group was lower than that in the TAPP group: (1.68 ± 0.39) scores vs. (1.97 ± 0.46) scores, P<0.05. After operation for 3 d, the levels of serum superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) in the modified TEP group were higher than those in the TAPP group: (92.79 ± 8.82) μmol/L vs. (84.40 ± 7.36) μmol/L, (81.52 ± 9.37) U/L vs. (75.75 ± 8.50) U/L; and the level of malondialdehyde (MDA) in the modified TEP group was lower than that in the TAPP group: (23.42 ± 3.3) μmol/L vs. (26.71 ± 3.92) μmol/L; the differences were statistically significant ( P<0.05). There was no significant difference in 1-year recurrence rate between the two groups ( P>0.05). One year after operation, the levels of acid phosphatase (ACP), fructose (FRU) and α- glucosidase (α- Glu) in the modified TEP group were higher than those in the TAPP group: (180.87 ± 20.15) kU/L vs. (159.85 ± 14.50) kU/L, (3.37 ± 0.84) g/L vs.(2.53 ± 0.67) g/L, (62.94 ± 6.25) kU/L vs. (43.96 ± 5.31) kU/L, the differences were statistically significant ( P<0.05). Conclusions:Both modified TEP and TAPP are effective methods for the treatment of inguinal hernia, but the former can reduce surgical trauma, recover quickly, and protect normal reproductive function.
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ABSTRACT Introduction: Inguinal hernia and varicocele are common conditions in male population. Laparoscopy brings the opportunity to treat them simultaneously, through the same incision. However, there are different opinions about the risks for testicular perfusion of multiple procedures in the inguinal region. In this study, we assessed the feasibility of simultaneous laparoscopic procedures by studying clinical and surgical outcomes of patients undergoing bilateral inguinal hernioplasty using the transabdominal preperitoneal (TAPP) technique with and without concomitant bilateral laparoscopic varicocelectomy (VLB). Methods: a sample of 20 patients from the University Hospital of USP-SP with indirect inguinal hernia and varicocele with indication for surgical correction was selected. Patients were randomized into two groups, 10 undergoing TAPP (Group I) and 10 undergoing simultaneous TAPP and VLB (Group II). Data regarding total operative time, complications and postoperative pain was gathered and analyzed. Results: there was no statistical difference between groups regarding total operative time and postoperative pain. Only one complication (spermatic cord hematoma) was observed in Group I and no complications were observed in Group II. Conclusions: simultaneous TAPP and VLB in was shown to be effective and safe, which provides a basis for conducting studies on larger scales.
RESUMO Introdução: hérnia inguinal e varicocele são doenças comuns na população masculina. O advento da laparoscopia traz a oportunidade de tratá-las simultaneamente, pelo mesmo acesso. Entretanto, existem divergências sobre os riscos para a perfusão testicular de múltiplos procedimentos na região inguinal. Neste estudo, avaliamos a viabilidade de procedimentos laparoscópicos simultâneos estudando resultados clínicos e cirúrgicos de pacientes submetidos à hernioplastia inguinal bilateral pela técnica transabdominal préperitoneal (TAPP) com e sem varicocelectomia laparoscópica bilateral (VLB) concomitante. Métodos: uma amostra de 20 pacientes do Hospital Universitário da USP-SP com hérnia inguinal indireta e varicocele com indicação de correção cirúrgica foi selecionada. Os pacientes foram randomizados em dois grupos, sendo 10 submetidos à TAPP (Grupo I) e 10 submetidos à TAPP e VLB simultâneas (Grupo II). O tempo operatório total, complicações e dor pós-operatória foram coletados e analisados. Resultados: não houve diferença estatística entre os grupos com relação ao tempo operatório total e à dor pós-operatória. Apenas uma complicação (hematoma do cordão espermático) foi observada no Grupo I e não foram observadas complicações no Grupo II. Conclusões: no mesmo procedimento, submeter pacientes à TAPP e à VLB no mesmo procedimento se mostrou eficaz e seguro, o que fornece embasamento para a realização de estudos em maiores escalas.
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Objetivo: Determinar cuáles son los factores de riesgo mayormente relacionados a cirugia de emergencia por hernia inguinal en pacientes que acuden al Hospital Militar Central de enero 2020 a julio 2022. Métodos: Estudio analítico, observacional retrospectivo, transversal y cuantitativo. En cuanto a los datos del manejo quirurgico de hernia inguinal, fueron obtenidos de las historias clínicas y recopiladas en una base de datos del sistema interno de gestion Hospitalaria del Hospital Militar central. Se relacionaron estadisticas descriptivas como porcentajes, promedios y tablas de frecuencias. Resultados: En el Hospital Militar Central se establece una edad de frecuencia de hernia inguinal de 60 - 79 años se presentan en 34% se establece que existe cirugia de emergencia por hernia inguinal, de los 50 - 79 años en principalmente.Con respecto a la variable sexo se observo que el femenino representan el 10% y los masculinos se establecen en 90% de ellos que presentan el diagnostico de hernia inguinal.Los pacientes que presentan antecedentes de enfermedad pulmonar crónica está presente en el 9% , como factor de riesgo de tabaqiuismo se establecio que se encuentra presente en el 67% de los pacientes que se incluyeron en este estudio, dentro de los cuales 80% fueron intervenidos de emergencia para hernioplastia y un 20% fueron intervenidos quirurgicamente de manera electiva.
Objective: To determine which are the risk factors mostly related to emergency surgery for inguinal hernia in patients who attend the central military hospital from January 2020 to July 2022. Methods: Analytical, observational, retrospective, cross-sectional and quantitative study. Regarding the data on the surgical management of inguinal hernia, they were obtained from the medical records and compiled in a database of the internal hospital management system of the central military hospital. For the descriptive analyzes we worked with percentages, means and frequency tables, the associations with Pearson's chi square. The odds ratio (OR) with 95% confidence intervals (CI) was calculated as a scale of strength of association. Results. In the central military hospital, an age frequency of inguinal hernia of x0 - x0 years is established, they are presented in % and patients with 61 - 70 years are present in 54.5% of them, it is established that there is emergency surgery for inguinal hernia, of the 50 - 60 years in mainly With respect to the sex variable, it was observed that the female represent the % and the male are established in % of them that present the diagnosis of inguinal hernia Patients with a history of chronic lung disease is present in the %, as a risk factor for smoking it was established that it is present in the % of the patients included in this study, in addition to the occupational situation of mainly high-ranking personnel. of %, within which % underwent emergency surgery for hernioplasty and % underwent elective surgery.
Subject(s)
Hernia, Inguinal , Recurrence , Risk FactorsABSTRACT
Introdução: As operações laparoscópicas têm aumentado anualmente, bem como os casos de prevalência das hérnias da parede abdominal. Com isso, as técnicas de se realizar as operações, bem como certos procedimentos vem sendo estudados. Uma das questões debatidas é a respeito do tipo de fixação da tela. Objetivo: Avaliar as técnicas de fixação da tela na cirurgia laparoscópica ventral da hérnia inguinal. Método: Trata-se de um estudo de revisão sistemática. Três bases de dados foram consultadas: Cochrane Database of Systematic Reviews (CDSR), EMBASE e PUBMED. Durante as buscas foram utilizados descritores com vocabulário controlado e text words. Resultados: Em relação ao desenho do estudo 1 revisão incluiu apenas ECA, 2 ECA e ECNA e 1 combinou a inclusão de ECA e estudos observacionais. Em relação ao tipo de fixação 2 estudos compararam os efeitos da fixação por tacha vs. cola de fibrina e outros 2 a comparação da fixação do grampo vs. cola de fibrina. De todos os desfechos de metanálise avaliados, apenas a redução da dor inguinal crônica pela fixação por cola de fibrina foi estatisticamente superior ao método de fixação mecânico em 3 dos 4 estudos. Conclusão: Os achados mostram que a diferença entre as técnicas de fixação da tela na cirurgia laparoscópica ventral da hérnia inguinal é que a fixação por cola diminui a incidência de dor crônica pós-operatória.
Introduction: Laparoscopic operations have increased annually, as well as the prevalence of abdominal wall hernias. With this, the techniques of performing the operations, as well as certain procedures, have been studied. One of the debated questions is about the type of fixation of the mesh. Objective: To evaluate mesh fixation techniques in ventral laparoscopic surgery for inguinal hernia. Method: This is a systematic review. Three databases were consulted: Cochrane Database of Systematic Reviews (CDSR), EMBASE and PUBMED. During the searches, descriptors with controlled vocabulary and text words were used. Results: Regarding the study design, 1 review included only ACE, 2 ACE and ECNA and 1 combined the inclusion of ACE and observational studies. Regarding the type of fixation, 2 studies compared the effects of stud fixation vs. fibrin glue and 2 others comparison of staple vs. fibrin glue. Of all the meta-analysis outcomes evaluated, only the reduction of chronic groin pain by fibrin glue fixation was statistically superior to the mechanical fixation method in 3 of 4 studies. Conclusion: The findings show that the difference between mesh fixation techniques in laparoscopic ventral inguinal hernia surgery is that glue fixation decreases the incidence of postoperative chronic pain.
Subject(s)
HumansABSTRACT
ABSTRACT Introduction: it is estimated that approximately 20 million people undergo inguinal hernia surgery annually in the world, with the Lichtenstein technique being the most performed surgical procedure. The objective of this study is to analyze the knowledge of the technical principles used in the Lichtenstein technique. Method: Survey-type intersectional study approved by the research ethics committee of São Camilo University Center (CAAE: 70036523.1.0000.0062). During the research period, 11,622 e-mails were sent to members of the main national surgical societies with research on the technical principles of Lichtenstein surgery. The survey was carried out using an electronic form with 10 multiple-choice questions. The form was answered anonymously on the SurveyMonkey and Google Forms platforms. Result: 744 responses were received to the electronic form. Based on this number of respondents, our survey has a confidence level of 95% with a margin of error of 3.5%. It was observed that there is no standardization of the technique among the majority of responders (53.4%). Many surgeons still perform digital dissection of the spermatic cord (47%). A small number of interviewees (15.2%) performed sutures with absorbable thread in the region of the internal oblique aponeurosis, while more than half (55.2%) continued to perform sutures with non-absorbable thread. Most surgeons use a small overlap or fix the mesh juxtaposed to the pubic symphysis (51%). Conclusion: Our research identified that a small percentage of respondents adequately know the technical principles of Lichtenstein surgery. The result brings us new insights into the need to review Lichtenstein technique.
RESUMO Introdução: estima-se que aproximadamente 20 milhões de pessoas sejam submetidas a cirurgia de hérnia inguinal anualmente no mundo, sendo a técnica de Lichtenstein o procedimento cirúrgico mais realizado. O objetivo desse estudo é analisar o conhecimento dos principios técnicos empregados na técnica de Lichtenstein. Método: estudo tipo levantamento interseccional aprovado pelo comitê de ética em pesquisa do Centro Universitário São Camilo (CAAE: 70036523.1.0000.0062). Durante o período da pesquisa foram encaminhados 11.622 e-mails aos membros das principais sociedades cirúrgicas nacionais com uma pesquisa sobre os princípios técnicos da cirurgia de Lichtenstein. A pesquisa foi realizada por formulário eletrônico com 10 questões de múltipla escolha. O formulário foi respondido de forma anônima nas plataformas SurveyMonkey e Google Forms. Resultado: foram recebidos 744 respostas ao formulário eletrônico. Com base nesse número de respondedores, nossa pesquisa apresenta grau de confiança de 95% com margem de erro de 3,5%. Foi observado que não há padronização da técnica entre a maioria dos respondedores (53.4%). Muitos cirurgiões ainda fazem dissecção digital do funículo espermático (47%). Um pequeno número de entrevistados (15,2%) realizam sutura com fio absorvível na região da aponeurose do obliquo interno, enquanto, mais da metade (55,2%) continua fazendo sutura com fio inabsorvível. A maior parte dos cirurgiões utilizam overlap pequeno ou fixam a tela justaposta a sínfise púbica (51%). Conclusão: nossa pesquisa identificou que uma porcentagem pequena dos entrevistados conhecem adequadamente os princípios técnicos da cirurgia de Lichtenstein. O resultado nos traz novas percepções sob a necessidade de revistar a consagrada técnica de Lichtenstein.
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ABSTRACT BACKGROUND: It is known that elective inguinal hernioplasties are safe procedures, but in an emergency setting, they have higher rates of complications and hospital costs. Despite this, quantitative studies on the subject in Brazil are still scarce. AIMS: To evaluate the trend in hospitalization rates, hospital mortality, and costs for inguinal hernia in an emergency, regarding gender and age group. METHODS: This is a time series study with data from the Unified Health System (SUS), at the national level, from 2010 to 2019. RESULTS: The overall hospitalization rate (p=0.007; b<0,02) in all age groups (p<0.005; b<0) in both genders indicated a decreasing trend. The general mortality rate in both genders and in most age groups showed an increasing trend (p<0.005), as well as the cost of hospitalization in all age groups of both genders. CONCLUSIONS: Urgent hospitalization rates for inguinal hernia in Brazil have shown a steady or decreasing trend; however, hospital mortality and costs per hospitalization have demonstrated an increasing trend in recent years.
RESUMO RACIONAL: Sabe-se que as hernioplastias inguinais eletivas são procedimentos seguros, mas que, em caráter de urgência, têm maiores taxas de complicações e custos hospitalares. Apesar disso, ainda são escassos os estudos quantitativos sobre o tema no Brasil. OBJETIVOS: Avaliar a tendência das taxas de internação, mortalidade hospitalar e custos por hérnia inguinal em caráter de urgência, quanto ao sexo e faixa etária. MÉTODOS: Trata-se de um estudo de séries temporais com dados do Sistema Único de Saúde (SUS), em nível nacional, no período de 2010 a 2019. RESULTADOS: A taxa de internação geral (p=0,007; b<0,02) em todas as faixas etárias (p<0,005; b<0) nos dois sexos indicou tendência decrescente. A taxa de mortalidade geral em ambos os sexos e na maioria das faixas etárias apresentou tendência crescente (p<0,005), assim como o custo da internação em todas as faixas etárias de ambos os sexos. CONCLUSÕES: As taxas de internação em caráter de urgência por hérnia inguinal, no Brasil, apresentaram tendência estacionária ou decrescente, entretanto, a mortalidade hospitalar e os custos por internação mostraram tendência crescente nos últimos anos.