Skip to main content
Erschienen in:

22.07.2017 | Original Article

Umbilical hernia repair in pregnant patients: review of the American College of Surgeons National Surgical Quality Improvement Program

verfasst von: I. N. Haskins, M. J. Rosen, A. S. Prabhu, R. L. Amdur, S. Rosenblatt, F. Brody, D. M. Krpata

Erschienen in: Hernia | Ausgabe 5/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Umbilical hernias present commonly during pregnancy secondary to increased intra-abdominal pressure. As a result, umbilical hernia incarceration or strangulation may affect pregnant females. The purpose of this study is to detail the operative management and 30-day outcomes of umbilical hernias in pregnant patients using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP).

Methods

All female patients undergoing umbilical hernia repair during pregnancy were identified within the ACS-NSQIP. Preoperative patient variables, intraoperative variables, and 30-day patient morbidity and mortality outcomes were investigated using a variety of statistical tests.

Results

A total of 126 pregnant patients underwent umbilical hernia repair from 2005 to 2014; 73 (58%) had incarceration or strangulation at the time of surgical intervention. The majority of patients (95%) underwent open umbilical hernia repair. Superficial surgical site infection was the most common morbidity in patients undergoing open umbilical hernia repair.

Conclusions

Based on review of the ACS-NSQIP database, the incidence of umbilical hernia repair during pregnancy is very low; however, the majority of patients required repair for incarceration of strangulation. When symptoms develop, these hernias can be repaired with minimal 30-day morbidity to the mother. Additional studies are needed to determine the long-term recurrence rate of umbilical hernia repairs performed in pregnant patients and the effects of surgical intervention and approach on the fetus.
Literatur
1.
Zurück zum Zitat Buch KE, Tabrizian P, Divino CM (2008) Management of hernias in pregnancy. J Am Coll Surg 207(4):539–542CrossRefPubMed Buch KE, Tabrizian P, Divino CM (2008) Management of hernias in pregnancy. J Am Coll Surg 207(4):539–542CrossRefPubMed
2.
3.
Zurück zum Zitat Augustin G, Majerovic M (2007) Non-obstetrical acute abdomen during pregnancy. Eur J Obstet Gynecol Reprod Biol 131(1):4–12CrossRefPubMed Augustin G, Majerovic M (2007) Non-obstetrical acute abdomen during pregnancy. Eur J Obstet Gynecol Reprod Biol 131(1):4–12CrossRefPubMed
5.
Zurück zum Zitat Cox TC, Huntington CR, Blair LJ, Prasad T et al (2016) Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients. Surg Endosc 30:593–602CrossRefPubMed Cox TC, Huntington CR, Blair LJ, Prasad T et al (2016) Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients. Surg Endosc 30:593–602CrossRefPubMed
7.
Zurück zum Zitat Jensen KK, Henriksen NA, Jorgensen LN (2015) Abdominal wall hernia and pregnancy: a systematic review. Hernia 19(5):689–696CrossRefPubMed Jensen KK, Henriksen NA, Jorgensen LN (2015) Abdominal wall hernia and pregnancy: a systematic review. Hernia 19(5):689–696CrossRefPubMed
8.
Zurück zum Zitat Oma E, Jensen KK, Jorgensen LN (2016) Recurrent umbilical or epigastric hernia during and after pregnancy: a nationwide cohort study. Surgery 159(6):1677–1683CrossRefPubMed Oma E, Jensen KK, Jorgensen LN (2016) Recurrent umbilical or epigastric hernia during and after pregnancy: a nationwide cohort study. Surgery 159(6):1677–1683CrossRefPubMed
9.
Zurück zum Zitat Arroya A, Garcia P, Perez F, Andreu J et al (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 88(10):1321–1323CrossRef Arroya A, Garcia P, Perez F, Andreu J et al (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 88(10):1321–1323CrossRef
10.
Zurück zum Zitat Sanjay P, Reid TD, Davies EL, Arumugam PJ et al (2005) Retrospective comparison of mesh and sutured repair for adult umbilical hernias. Hernia 9(3):248–251CrossRefPubMed Sanjay P, Reid TD, Davies EL, Arumugam PJ et al (2005) Retrospective comparison of mesh and sutured repair for adult umbilical hernias. Hernia 9(3):248–251CrossRefPubMed
11.
Zurück zum Zitat Cohen-Kerem R, Railton C, Oren D, Lishner M et al (2005) Pregnancy outcome following non-obstetric surgical intervention. Am J Surg 190(3):467–473CrossRefPubMed Cohen-Kerem R, Railton C, Oren D, Lishner M et al (2005) Pregnancy outcome following non-obstetric surgical intervention. Am J Surg 190(3):467–473CrossRefPubMed
12.
Zurück zum Zitat Odibo I (2013) Non-obstetric surgery during pregnancy. powerpoint. Little Rock, AR: Division of Maternal-Fetal Medicine Odibo I (2013) Non-obstetric surgery during pregnancy. powerpoint. Little Rock, AR: Division of Maternal-Fetal Medicine
13.
Zurück zum Zitat VandeVelde M, DeBuck F (2007) Anesthesia for non-obstetric surgery in the pregnant patient. Minerva Anestesiol 73(4):235–240 VandeVelde M, DeBuck F (2007) Anesthesia for non-obstetric surgery in the pregnant patient. Minerva Anestesiol 73(4):235–240
Metadaten
Titel
Umbilical hernia repair in pregnant patients: review of the American College of Surgeons National Surgical Quality Improvement Program
verfasst von
I. N. Haskins
M. J. Rosen
A. S. Prabhu
R. L. Amdur
S. Rosenblatt
F. Brody
D. M. Krpata
Publikationsdatum
22.07.2017
Verlag
Springer Paris
Erschienen in
Hernia / Ausgabe 5/2017
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-017-1633-8

Neu im Fachgebiet Chirurgie

Verbände und Cremes gegen Dekubitus: „Wir wissen nicht, was sie bringen!“

Die Datenlage zur Wirksamkeit von Verbänden oder topischen Mitteln zur Prävention von Druckgeschwüren sei schlecht, so die Verfasser einer aktuellen Cochrane-Studie. Letztlich bleibe es unsicher, ob solche Maßnahmen den Betroffenen nutzen oder schaden.

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

US-Team empfiehlt Gastropexie nach Hiatushernien-Op.

Zur Vermeidung von Rezidiven nach Reparatur einer paraösophagealen Hiatushernie sollte einem US-Team zufolge der Magen bei der Op. routinemäßig an der Bauchwand fixiert werden. Das Ergebnis einer randomisierten Studie scheint dafür zu sprechen.

Mit Lidocain kommt der Darm nicht schneller in Schwung

Verzögertes Wiederanspringen der Darmfunktion ist ein Hauptfaktor dafür, wenn Patientinnen und Patienten nach einer Kolonresektion länger als geplant im Krankenhaus bleiben müssen. Ob man diesem Problem mit Lidocain vorbeugen kann, war Thema einer Studie.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.