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Manual reduction for incarcerated obturator hernia.

Yusuke Gokon1, Yusuke Ohki2, Takahiro Ogino2

  • 1Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan. yusukegokon@surg.med.tohoku.ac.jp.

Scientific Reports
|April 4, 2023
PubMed
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Manual reduction for incarcerated obturator hernias can be effective, but requires careful monitoring. Some patients may still need emergent surgery due to delayed complications like bowel perforation.

Area of Science:

  • Abdominal Surgery
  • Gastroenterology
  • Surgical Innovation

Background:

  • Incarcerated obturator hernias often necessitate emergent surgery, carrying significant risks.
  • Elective surgery following non-invasive manual reduction has been reported, prompting further investigation.

Purpose of the Study:

  • To evaluate the efficacy and safety of manual reduction followed by elective surgery for incarcerated obturator hernias.
  • To compare outcomes between patients undergoing manual reduction and those requiring immediate emergent surgery.

Main Methods:

  • Retrospective review of 50 incarcerated obturator hernia cases (2010-2022).
  • Analysis of manual reduction success rates, subsequent surgical approaches, and postoperative outcomes.
  • Categorization of patients into reducible (manual reduction) and irreducible (emergent surgery) groups.

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Main Results:

  • Manual reduction was attempted in 62% of patients, with a 42% success rate.
  • Elective mesh repair via extraperitoneal approach was common after successful reduction.
  • Two patients experienced late complications (constriction, perforation) requiring emergent surgery during the waiting period.
  • Postoperative complication rates were 5% for reducible and 22% for irreducible hernias; mortality was 0% in both groups.

Conclusions:

  • Manual reduction is a viable initial approach for select incarcerated obturator hernias.
  • Close observation is crucial post-reduction due to the risk of delayed complications.
  • While safe, manual reduction requires careful patient selection and monitoring to avoid adverse events.