Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study
Background Incarcerated hernia is a common surgical emergency with considerable morbidity or even mortality. Manual reduction (taxis) and elective surgery could be an alternative management approach. This study examines the role of taxis with the adjuvant use of the visual analogue scale (VAS) score...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2022-01-01
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| Series: | The Surgery Journal |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1742178 |
| _version_ | 1818322281809575936 |
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| author | Konstantinos Bouliaris Matthaios Efthimiou Paraskevi Chatzikomnitsa Christina Kolla Christos Doudakmanis Konstantinos Zervas Anargiros Giaglaras Georgios D. Koukoulis |
| author_facet | Konstantinos Bouliaris Matthaios Efthimiou Paraskevi Chatzikomnitsa Christina Kolla Christos Doudakmanis Konstantinos Zervas Anargiros Giaglaras Georgios D. Koukoulis |
| author_sort | Konstantinos Bouliaris |
| collection | DOAJ |
| description | Background Incarcerated hernia is a common surgical emergency with considerable morbidity or even mortality. Manual reduction (taxis) and elective surgery could be an alternative management approach. This study examines the role of taxis with the adjuvant use of the visual analogue scale (VAS) score in treating incarcerated hernias and thereby decreasing the emergency surgery rate, especially during the novel coronavirus disease 2019 (COVID-19) pandemic.
Methods All adult patients admitted to the emergency department of our hospital with incarcerated hernias of anterior abdominal wall were prospectively submitted to hernia manual reduction. The VAS score was used as an adjuvant tool for monitoring the success of this maneuver. Patients with successful taxis and low VAS score were hospitalized for a 24-hour period of observation. On their discharge, they were scheduled for an elective hernia repair. Patients with unsuccessful taxis or with less than a 50% reduction in VAS score after successful taxis were submitted to emergency surgical repair. Age, sex, type of hernias, time until taxis, VAS scores before and after taxis, length of hospital stay, and adverse events for both groups were recorded.
Results Between September 2018 and September 2020, 86 patients with incarcerated hernias were included. The types of hernias were incisional in 8 patients, umbilical in 15 patients, inguinal in 56 patients, and femoral in 7 patients. Taxis was successful in 66% of patients with a mean reduction in VAS score from 83 to 17 mm. Following successful taxis, patients were hospitalized for a 24-hour period of observation. No taxis-related complications were observed. Fifty-two patients were safely discharged from hospital and scheduled for an elective repair during the first month. Thirty-four patients were operated emergently. Five patients had successful taxis but with a reduction of posttaxis VAS score less than 50% (a mean reduction from 86 to 62 mm), while taxis failed in twenty-nine patients. Patients with emergency surgery had longer time until reduction and longer stay of hospitalization. In this group, two patients required admission to the intensive care unit while one patient died.
Conclusion In this protocolized approach, taxis is a safe and feasible option for most patients with incarcerated hernias. It should be kept in our armament, especially in times when emergency surgery capabilities are under strain like the ongoing COVID-19 pandemic. |
| first_indexed | 2024-12-13T10:54:19Z |
| format | Article |
| id | doaj.art-6b0ffd845e124e98b47e6f7184cfaa2c |
| institution | Directory Open Access Journal |
| issn | 2378-5128 2378-5136 |
| language | English |
| last_indexed | 2024-12-13T10:54:19Z |
| publishDate | 2022-01-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | The Surgery Journal |
| spelling | doaj.art-6b0ffd845e124e98b47e6f7184cfaa2c2022-12-21T23:49:39ZengThieme Medical Publishers, Inc.The Surgery Journal2378-51282378-51362022-01-010801e46e5110.1055/s-0041-1742178Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective StudyKonstantinos Bouliaris0Matthaios Efthimiou1Paraskevi Chatzikomnitsa2Christina Kolla3Christos Doudakmanis4Konstantinos Zervas5Anargiros Giaglaras6Georgios D. Koukoulis7Department of General Surgery, General Hospital of Larissa, Larissa, GreeceDepartment of General Surgery, General Hospital of Larissa, Larissa, GreeceDepartment of General Surgery, General Hospital of Larissa, Larissa, GreeceDepartment of General Surgery, General Hospital of Larissa, Larissa, GreeceDepartment of General Surgery, General Hospital of Larissa, Larissa, GreeceDepartment of General Surgery, General Hospital of Larissa, Larissa, GreeceDepartment of General Surgery, General Hospital of Larissa, Larissa, GreeceDepartment of General Surgery, General Hospital of Larissa, Larissa, GreeceBackground Incarcerated hernia is a common surgical emergency with considerable morbidity or even mortality. Manual reduction (taxis) and elective surgery could be an alternative management approach. This study examines the role of taxis with the adjuvant use of the visual analogue scale (VAS) score in treating incarcerated hernias and thereby decreasing the emergency surgery rate, especially during the novel coronavirus disease 2019 (COVID-19) pandemic. Methods All adult patients admitted to the emergency department of our hospital with incarcerated hernias of anterior abdominal wall were prospectively submitted to hernia manual reduction. The VAS score was used as an adjuvant tool for monitoring the success of this maneuver. Patients with successful taxis and low VAS score were hospitalized for a 24-hour period of observation. On their discharge, they were scheduled for an elective hernia repair. Patients with unsuccessful taxis or with less than a 50% reduction in VAS score after successful taxis were submitted to emergency surgical repair. Age, sex, type of hernias, time until taxis, VAS scores before and after taxis, length of hospital stay, and adverse events for both groups were recorded. Results Between September 2018 and September 2020, 86 patients with incarcerated hernias were included. The types of hernias were incisional in 8 patients, umbilical in 15 patients, inguinal in 56 patients, and femoral in 7 patients. Taxis was successful in 66% of patients with a mean reduction in VAS score from 83 to 17 mm. Following successful taxis, patients were hospitalized for a 24-hour period of observation. No taxis-related complications were observed. Fifty-two patients were safely discharged from hospital and scheduled for an elective repair during the first month. Thirty-four patients were operated emergently. Five patients had successful taxis but with a reduction of posttaxis VAS score less than 50% (a mean reduction from 86 to 62 mm), while taxis failed in twenty-nine patients. Patients with emergency surgery had longer time until reduction and longer stay of hospitalization. In this group, two patients required admission to the intensive care unit while one patient died. Conclusion In this protocolized approach, taxis is a safe and feasible option for most patients with incarcerated hernias. It should be kept in our armament, especially in times when emergency surgery capabilities are under strain like the ongoing COVID-19 pandemic.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1742178herniavisual analog pain scorecoronavirusmanual reductiontaxis |
| spellingShingle | Konstantinos Bouliaris Matthaios Efthimiou Paraskevi Chatzikomnitsa Christina Kolla Christos Doudakmanis Konstantinos Zervas Anargiros Giaglaras Georgios D. Koukoulis Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study The Surgery Journal hernia visual analog pain score coronavirus manual reduction taxis |
| title | Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study |
| title_full | Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study |
| title_fullStr | Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study |
| title_full_unstemmed | Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study |
| title_short | Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study |
| title_sort | manual reduction of incarcerated abdominal wall hernias a feasible option during covid 19 pandemic a prospective study |
| topic | hernia visual analog pain score coronavirus manual reduction taxis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1742178 |
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