Bowel obstruction due to obturator hernia: A retrospective cohort study comparing the outcomes between two consecutive decades

Abstract

Aim: The prevalence of obturator hernia increaseswith the ageing population. This study aims to reviewthe surgical outcome of emergency repair for patients with obstructing obturator hernia. Methods: All cases presented with obturator herniasince 1998 were included. Patients’ characteristics,operative findings, and postoperative outcomes wereretrospectively reviewed and analyzed between twoconsecutive decades (1998-2007 vs 2008-2017) withSPSS version 20. Results: All were Chinese females with a median ageof 88 (range 77 - 100). Though the patients had moreadvanced median age (89.5 vs 87) in the second dec-ade, comorbidities were similar between these twoperiods. In total 41 patients underwent 45 operationsand 28/46 (62.2%) were performed in the second dec-ade. The most common postoperative complicationwas pneumonia (29.4% from 1998-2007 vs 39.3% from2008-2017 respectively). However, less intensive careunit admissions (17.6% vs 14.3%) and tracheal intuba-tion (17.6% vs 3.6%) were noted in the second dec-ade. Probably this may be associated with frequentbronchoscopic toileting (11.8% vs 21.4%) and morenon-invasive ventilatory support (5.9% vs 14.3%) inthis period. No significant differences were noted inoverall complication rate (64.7% vs 64.3%, p=1.00)and 30-day mortality (17.9% vs 17.6%, p=1.00). Conclusions: Advanced age was noticed in ourpatients presenting with obstructing obturator hernia.Despite high incidence of postoperative pneumoniain these elderly, with frequent bronchoscopic toiletand non-invasive ventilator support, the overall com-plication rate and mortality were com parable in thesetwo consecutive decades.