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  • 1
    Online Resource
    Online Resource
    P116 “KIGNSNORTH MODIFIED SCORE” FOR OPEN INGUINAL HERNIA REPAIR COMPLICATIONS PREDICTION. POINTHER STUDY
    Oxford University Press (OUP) ; 2021
    In:  British Journal of Surgery Vol. 108, No. Supplement_8 ( 2021-11-24)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 108, No. Supplement_8 ( 2021-11-24)
    Abstract: Aim of our study is to analysis of postoperative outcomes (30 days) after elective unilateral open anterior inguinal hernia repair and prove correlation to modified Kingsnorth (MK) score classification system. Material and Methods Prospective registered (NTC 04806828) study of all consecutive unilateral open anterior groin hernia repair performed at a University Hospital General Surgery Department from January 2019 to December 2020. Data was stored at National Spanish Groin Hernia Registry (EVEREG). All patients were preoperatively classified using MK score. Statistical analysis of postoperative complications and their relation to preoperative modified Kingsnorth scale was performed. Results 403 patients were included. 61% were performed as ambulatory surgery. 15.7% had more than 5-8 MK punctuation. A total of 62 patients had postoperative complications, 81% of all complications were classified as Clavien I. Higher Surgery duration was directly related to higher MK (Pearson's correlation 0.291; P  & lt; 0.0001score.) Statistically significant relationship with the presence of higher rate of complications were a KN score of 5-8 (OR 2.7; 95% CI 1.07-4.82; P = 0.03) whereas performance of surgery by an abdominal wall surgery specialist had less complications (OR 0.28; 95% CI 0.08-0.92; P = 0.03) Conclusions MK classification predicts surgical wound complications on patients who undergo a primary unilateral inguinal hernia surgery. A KN score of 5-8 had a higher probability of wound complications. When surgery was performed by a specialist in abdominal wall surgery, less postoperative complications were observed.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znab395.109
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    O06 PATIENT-REPORTED KNOWLEDGE OF HERNIA SURGERY: A QUANTITATIVE STUDY OF FIRST TIME REFERRED PATIENTS TO AN ABDOMINAL WALL UNIT FOR HERNIA REPAIR
    Oxford University Press (OUP) ; 2021
    In:  British Journal of Surgery Vol. 108, No. Supplement_8 ( 2021-11-24)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 108, No. Supplement_8 ( 2021-11-24)
    Abstract: The objective of this study was to gather information on patient-reported knowledge (PRK) in the field of hernia surgery. Material and Methods A prospective quantitative study was designed to explore different aspects of PRK and opinions regarding hernia surgery. Patients referred for the first time to a surgical service with a presumed diagnosis of hernia and eventual hernia repair were eligible, and those who gave consent completed a simple self-assessment questionnaire before the clinical visit. Results The study population included 449 patients (72.8% men, mean age 61.5). Twenty (4.5%) patients did not have hernia on physical examination. The patient’s perceived health status was “neither bad nor good” or “good” in 56.6% of cases. Also, more patients considered that hernia repair would be an easy procedure (35.1%) rather than a difficult one (9.8%). Although patients were referred by their family physicians, 32 (7.1%) answered negatively to the question of coming to the visit to assess the presence of a hernia. The most important reason of the medical visit was to receive medical advice (77.7%), to be operated on as soon as possible (40.1%) or to be included in the surgical waiting list (35.9%). Also, 46.1% of the patients considered that they should undergo a hernia repair and 56.8% that surgery will be a definitive solution. Conclusions PRK of patients referred for the first time to an abdominal wall surgery unit with a presumed diagnosis of hernia was quite limited and there is still a long way towards improving knowledge of hernia surgery.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znab396.005
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    O03 SMALL BITES AND PROPHYLACTIC MESH TO PREVENT INCISIONAL HERNIA IN HIGH-RISK PATIENTS. A MESH IS THE MOST POWERFUL TOOL
    Oxford University Press (OUP) ; 2021
    In:  British Journal of Surgery Vol. 108, No. Supplement_8 ( 2021-11-24)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 108, No. Supplement_8 ( 2021-11-24)
    Abstract: Small bites (SB) technique for closure of elective midline laparotomies (EMLs) and a prophylactic mesh (PM) in high-risk patients are suggested by guidelines to prevent incisional hernias (IHs) and burst abdomen (BA). Our aim was to implement a protocol combining both and to analyze its outcomes. Material and Methods Prospective data collection of all EMLs for one year. Results were analyzed at one month and during follow-up. The incidence of IH and BA was compared by groups depending on the use of a PM (M Group) or not (S Group), and in subgroups related to the closure technique: SB (Subgroups MSB and SSB) or not (Subgroups MLB and MSB). Results A lower number of BA was diagnosed in the M group (OR 0.0692; CI95% 0.008-0.56; P = 0.01) in 197 operations. 163 patients completed a mean follow-up of 29.23 months, with a lower frequency of IH in M group patients (OR = 0.769; CI 95% 0.65 - 0.91; P  & lt; 0.0001). Same differences persisted after a propensity matching score: BA (OR = 0.355; CI 95% 0.255 - 0.494; P  & lt; 0.0001) and IH (OR = 0.394; CI 95% 0.24 - 0.61; P  & lt; 0.0001). Comparing suturing techniques by subgroups any difference in IH and BA appeared. PM was the main factor related to reduction of IH (HR 11.794; CI 95% 4.29 - 32.39; P  & lt; 0.0001). Conclusions A PM is the most powerful tool for prevention both IH and BA after EMLs, regardless of the closure technique in patients at high-risk for IHs.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znab396.002
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    P035 EMERGENCY BILATERAL GORIN HERNIA REPAIR IN UNILATERAL COMPLICATED INGUINAL HERNIA REAPIR WITH CONCOMITNAT CONTRALATERAL HERNIA. COHORTS COMPARATIVE OUTCOMES ANALYSIS USING PROPENSITY SCORE MATCHING
    Oxford University Press (OUP) ; 2021
    In:  British Journal of Surgery Vol. 108, No. Supplement_8 ( 2021-11-24)
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 108, No. Supplement_8 ( 2021-11-24)
    Abstract: Aim of our study was to analyze outcomes and safety of bilateral inguinal hernia repair in unilateral groin complicated hernia with contralateral groin hernia. Material and Methods Retrospective cohorts study following STROBE statements on a prospective Emergency Surgery Department database. Inclusion criteria were: patients with emergency hernia repair from 2008 to 2018, 18 years old. Unilateral or bilateral inguinal hernia repair without other abdominal wall hernia repairs. Comparative analysis between two group unilateral hernia repair (UH) vs bilateral hernia repair (BH) those patients with unilateral complicated inguinal hernia with contralateral inguinal hernia. Propensity score matching (PSM) between groups was performed to eliminate statistically groups differences. Outcomes between groups were analyzed with special attention to postoperative morbimortality and hernia recurrence. Results 341 patients were included, 38(11.1%) were performed bilateral hernia repair. Groups differences were: higher rate of inguinoscrotal inguinal hernia (36.8 vs 22.8), prophylactic antibiotics use (94.7 vs 81.8) and general Anesthesia use (52.6% vs 50.2%). General high rates of morbidity and mortality were observed (5.9% and 41.9) and 22 (6.5%) hernia repair recurrence were detected. After PSM no differences between surgery outcomes groups were observed with similar morbidity, recurrence or hospital stay. Conclusions Emergency inguinal hernia repair has high morbidity and mortality rates in our experience. Emergency Bilateral inguinal hernia repair in context of hernia complication seems safe without recurrence or hospital stay increase.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znab395.033
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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