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Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias

BACKGROUND: There is currently no grading standard for the degree of clinical and bowel morphological changes. The objective of this study was to define clinical and bowel morphological classifications and investigate the possible relationship with the characteristics of patients with incarcerated g...

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Autores principales: Duan, Sheng-jun, Liu, Hua-shui, Niu, Jun, Wang, Chun-xiang, Chen, Shou-hua, Wang, Ming-hai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930600/
https://www.ncbi.nlm.nih.gov/pubmed/24509901
http://dx.doi.org/10.12659/MSM.889786
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author Duan, Sheng-jun
Liu, Hua-shui
Niu, Jun
Wang, Chun-xiang
Chen, Shou-hua
Wang, Ming-hai
author_facet Duan, Sheng-jun
Liu, Hua-shui
Niu, Jun
Wang, Chun-xiang
Chen, Shou-hua
Wang, Ming-hai
author_sort Duan, Sheng-jun
collection PubMed
description BACKGROUND: There is currently no grading standard for the degree of clinical and bowel morphological changes. The objective of this study was to define clinical and bowel morphological classifications and investigate the possible relationship with the characteristics of patients with incarcerated groin hernias. MATERIAL/METHODS: We retrospectively studied 195 patients who underwent emergency hernia repair with simultaneous bowel resection between January 1992 and January 2012. We classified the degree of clinical and bowel morphological changes into 3 grades based on the incarceration time, intestinal morphology after damage, hernia sac integrity, degree of inflammation, and the presence/absence of bacterial growth, peritonitis signs, mechanical obstruction, cellulitis, and systemic shock. We also recorded patient characteristics and analyzed their relationships with these degrees according to our grading system. RESULTS: We identified 134, 42, and 19 cases of Grades I, II, and III of clinical and bowel morphological changes, respectively. Pearson’s chi-squared tests revealed that advanced age (P=0.001), presence of comorbid disease (P=0.002), and high American Society of Anesthesiologists (ASA) score (P=0.017) were related to the degree. Morbidity and mortality also showed significant relationships with the degree (P<0.001, P=0.005, respectively), especially with regard to post-operative infection. CONCLUSIONS: The proposed 3-stage classifications of clinical and bowel morphological changes can be used to objectively reflect the degree of bowel damage. Greater levels of the changes were associated with higher incidences of complications and increased mortality, especially for older patients with comorbid diseases and poor ASA scores. Urgent surgery should be performed to avoid bowel damage exacerbation.
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spelling pubmed-39306002014-02-21 Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias Duan, Sheng-jun Liu, Hua-shui Niu, Jun Wang, Chun-xiang Chen, Shou-hua Wang, Ming-hai Med Sci Monit Clinical Research BACKGROUND: There is currently no grading standard for the degree of clinical and bowel morphological changes. The objective of this study was to define clinical and bowel morphological classifications and investigate the possible relationship with the characteristics of patients with incarcerated groin hernias. MATERIAL/METHODS: We retrospectively studied 195 patients who underwent emergency hernia repair with simultaneous bowel resection between January 1992 and January 2012. We classified the degree of clinical and bowel morphological changes into 3 grades based on the incarceration time, intestinal morphology after damage, hernia sac integrity, degree of inflammation, and the presence/absence of bacterial growth, peritonitis signs, mechanical obstruction, cellulitis, and systemic shock. We also recorded patient characteristics and analyzed their relationships with these degrees according to our grading system. RESULTS: We identified 134, 42, and 19 cases of Grades I, II, and III of clinical and bowel morphological changes, respectively. Pearson’s chi-squared tests revealed that advanced age (P=0.001), presence of comorbid disease (P=0.002), and high American Society of Anesthesiologists (ASA) score (P=0.017) were related to the degree. Morbidity and mortality also showed significant relationships with the degree (P<0.001, P=0.005, respectively), especially with regard to post-operative infection. CONCLUSIONS: The proposed 3-stage classifications of clinical and bowel morphological changes can be used to objectively reflect the degree of bowel damage. Greater levels of the changes were associated with higher incidences of complications and increased mortality, especially for older patients with comorbid diseases and poor ASA scores. Urgent surgery should be performed to avoid bowel damage exacerbation. International Scientific Literature, Inc. 2014-02-08 /pmc/articles/PMC3930600/ /pubmed/24509901 http://dx.doi.org/10.12659/MSM.889786 Text en © Med Sci Monit, 2014 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License
spellingShingle Clinical Research
Duan, Sheng-jun
Liu, Hua-shui
Niu, Jun
Wang, Chun-xiang
Chen, Shou-hua
Wang, Ming-hai
Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias
title Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias
title_full Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias
title_fullStr Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias
title_full_unstemmed Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias
title_short Classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias
title_sort classifications of clinical and bowel morphological changes and their relationship with characteristics of patients with incarcerated groin hernias
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930600/
https://www.ncbi.nlm.nih.gov/pubmed/24509901
http://dx.doi.org/10.12659/MSM.889786
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