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Emergency hernia surgery at a high-volume tertiary centre: a 3-year experience
Thomas B Russell1, Hassan Elberm2
1Registrar in General Surgery, Department of General Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK.
ANZ Journal of Surgery
|January 21, 2021
Summary
Emergency abdominal wall hernia (AWH) surgery involves older, sicker patients and leads to significant complications. Timely elective surgery for high-risk individuals can improve outcomes and reduce hospital resource use.
Area of Science:
- Surgery
- Abdominal Wall Hernia
- Emergency Medicine
Background:
- Emergency abdominal wall hernia (AWH) surgery is often underestimated.
- This procedure carries significant patient morbidity and resource implications.
Purpose of the Study:
- To review the experience of a high-volume center in emergency AWH surgery.
- To analyze patient demographics, surgical details, and outcomes.
Main Methods:
- Retrospective review of emergency AWH operations from 2014-2017.
- Analysis included patient characteristics, hernia type, operative details, and post-operative outcomes.
- Key metrics: time to surgery, hospital stay, HDU/ICU admission, morbidity, and mortality.
Main Results:
- 198 patients reviewed; median age 67.4 years, 52.2% ASA III+.
- 47% had bowel involvement, associated with longer stays and higher HDU/ICU rates.
- Overall complication rate was 33.3%, with 1.51% inpatient mortality.
Conclusions:
- Emergency AWH surgery patients are elderly and comorbid.
- Significant morbidity and resource utilization highlight the need for risk stratification.
- Prompt elective surgery for high-risk patients is recommended.
