Candaş ERÇETİN, Ahmet Cem DURAL, MAHİR KIRNAP, Nazlı Ferhan SAYİT, TUGAN TEZCANER

Dağınık kırsal yerleşim bölgesinde boğulmuş fıtık ve geç başvuru sonuçları

Amaç: Dağınık nüfus yerleşimli ilimizde, hastanemize başvuran boğulmuş fıtık olgularının başvuru yeri ve süresine göre değerlendirilmesi amaçlandı. Yöntem Mayıs 2009-2011 arasında boğulmuş fıtık tanısı ile ameliyat edilen olgular retrospektif olarak değerlendirildi. Bulgular: Elli iki olgunun yaş ortalaması 53,6 , erkek/kadın oranı 48/4 idi. Kırsal bölgeden başvuru % 52 idi (n=27). Gecikmiş başvuru oranı, kırsal bölge yerleşimli olgularda % 33,3 idi (n=9). Ameliyat öncesi değerlendirmede olguların % 50'si (n=26) ASA II-III idi. En sık (% 52) omental inkarserasyon (n=27) görüldü. Olguların % 13,4'ünde rezeksiyon gerekli oldu. Olguların % 88,4'ünde Lichtenstein yöntemi ile herni tamiri uygulandı. Komplikasyon oranı % 15,3 (n=8) iken, kırsal bölge başvurularında % 18,5 idi. Ortalama hastanede kalış süresi 3,8 gün idi. Bir yıllık takip sürecinde 3 olguda (% 5,7) nüks görüldü. Sonuç: Kırsal bölgeden gecikmiş başvuru oranı yüksek olup anlamlı fark gözlenmedi. Elliiki olgunun değerlendirilmesinde; ilk 24 saat içinde girişim yapılan olgularda komplikasyon oranı ve hastanede kalış süresinin daha az olduğu görüldü.

The results of incarcerated hernias with delayed admission in a rural region with scattered settlement

Objective: The study was aimed to evaluate the outcomes of incarcerated hernias who were admitted to our emergency department in two years according to admission interval and place of residence. Methods: The records of patients undergoing emergency surgical operation for incarcerated hernias in our hospital between May 2009-2011 were analyzed retrospectively. Results: The mean age of 52 patients was 53.6 years, with a male/female ratio of 48/4. The admission rate from scattered rural settlement was 52% (n=27) and delayed admission rate was 33.3% (n=9) among these patients. Fifty percent of the patients (n=26) were classified as ASA II or III. Omentum was most frequently incarcerated, in 27 (52%) hernias. Resection was needed in 13.4% of the patients. Lichtenstein hernia repair was performed in 88.4% of the patients. The complication rate was 15.3% (n=8) and 18.5% for the patients admitted from a rural region. The length of hospitalization ranged from 1-34 days (mean 3.8). In our case series, there were 3 recurrences after one year follow-up. Conclusion: Although late hospitalization was more common among those who live in a rural region, no statistically significant difference was observed. We found a lower complication rate and shorter hospitalization when the patients were operated within first 24 hours of the incarceration.

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