Open AccessOutcomes of obstructed abdominal wall hernia: results from the UK national small bowel obstruction audit
Author(s) -
Matthew J. Lee,
Thomas M Drake,
Adele Sayers,
Ciaran Walsh,
Michael Davies,
Nicola Fearnhead,
John Abercrombie,
Austin G. Acheson,
Derek Alderson,
I D Anderson,
Simon P. Bach,
Zaed Hamady,
Daniel Hind,
Marianne Hollyman,
Sarah Hare,
Kathryn Lee,
John Northover,
Christopher Alan Lewis,
Paul Marriott,
Nick Maynard,
David Murray,
Gillian Tierney,
Azmina Verjee,
Jonathan Wild,
S. Abbott,
Yasser Abdulaal,
Salim Afshar,
J. Ah-Chuen,
Tasneem Ahmed,
MA Akhtar,
Farooq Akram,
Elaine M Aldred,
Amjad Ali,
Mohamed Aly,
Adaugo Amajuoyi,
VISHRANT AMIN,
Daren Anderson,
O. D. Anderson,
Alexander Andreou,
Abdul Basit Ansari,
S Appleton,
Rohan Ardley,
Fatima Arshad,
O Ashour,
Amani Asour,
A Athem,
M Athersmith,
Fares Ayoub,
Hussain Azeem,
Bilal Azhar,
T Badenoch,
Colin Baillie,
Dipankar Bandyopadhyay,
Juliet N. Barker,
Sarah Barker,
Benjamin Barkham,
Ralf Baron,
Jenifer Barrie,
E BarryYarrow,
Gareth Bashir,
Nick Battersby,
G Bazoua,
Nebil Behar,
Shashi Bellam,
C. Berger,
Samrat Singh Bhandarı,
S Bhasin,
Sarah N. Biggs,
Carly Bisset,
Lucy Blake,
Natalie Blencowe,
Tristan Boam,
Alex Boddy,
Catherine Boereboom,
M Bogdan,
Richard Bogle,
P Bohra,
Michael R. Boland,
Håkon A. Bolkan,
Cynthia-Michelle Borg,
Richard Boulton,
George Bouras,
Matthew J. Boyer,
J Boyle,
Graham Branagan,
H Brewer,
C Briggs,
Jack Broadhurst,
Eric N. Brown,
James Brown,
L Brown,
Oliver Brown,
K Burns,
K Butcher,
Melissa G. Butler,
Ben Byrne,
Leah Campbell,
Cameron P. Capper,
Mark Cartmell,
Therese V. Cash,
Sheila L. Chan,
N Chandratreya,
Jennifer Chapman,
Stephen J. Chapman,
Alexandros Charalabopoulos,
C Cheek,
Ksh Chok,
Keith Wai Keong Choong,
Maria Yui Kwan Chow,
Jared Chowdhury,
P Coe,
Philip G. Conaghan,
G. Conn,
Nicole Cook,
T. Cook,
Sheldon C. Cooper,
Julie Cornish,
David B. Cotton,
Christopher Michael Jason Cox,
Peter Coyne,
Richard Crook,
Joseph Crozier,
Giulio Cuffolo,
Pedro Cunha,
Nathan Curtis,
J Cutting,
K Da Costa,
L Silva,
Bhupati Bhusan Das,
Mark Davenport,
Justine Davies,
Thomas Davies,
A Day,
Saraswati Dayal,
S Dean,
Georgia Demetriou,
Fungai Dengu,
Richard Dennis,
Helen Dent,
P Dent,
Mohammed Deputy,
Laurence Devoto,
Giuseppe Di Benedetto,
Shiva Dindyal,
Eric D. Donnelly,
Paul Doody,
Eleftheria Douka,
C. Downham,
H Dowson,
H Edent,
Keith Edgerton,
N Ekpete,
Mirna Farran,
O Elamin,
M Eljaafari,
Nora Y. Elsaid,
Mohamed Elsharif,
Jennifer Evans,
Martin D.D. Evans,
Renee Ewe,
Anne Ewing,
Klaire Exarchou,
Rosalind Fallaize,
Morad Faoury,
S. Farag,
Eleonora Farinella,
G Faulkner,
Henry J.M. Ferguson,
Owain Fisher,
Jordan Fletcher,
Amir Forouzanfar,
Ashley A. Foster,
Ray Fox,
Nader Francis,
V Fretwell,
Didier Fung,
Emanuele Gammeri,
J Garnham,
Alistair Geraghty,
Alexandra Gilbert,
C Gill,
M. John Gill,
M. Boyd Gillespie,
Pasquale Giordano,
James Glasbey,
Mei Goh,
Allan M. Golder,
N Green,
Tine Grégoir,
T Grey,
E Groundwater,
T Grove,
Siona Growcott,
S. Gunasekaran,
H Habib,
J. B. Haddow,
Vijitha Chandima Halahakoon,
Constantine Halkias,
Claire Hall,
Alexander Hampson,
Laura Hancock,
Tarek N. Hanna,
Jonathan Hannay,
Athur Harikrishnan,
Rhian Harries,
G Harris,
Jessica N. Hartley,
James Harvey,
P Hawkin,
Jemma Hawkins,
Robert W. Healy,
Rachel Heard,
R Heartshorne,
S Heller,
L Hendra,
P Herrod,
N Heywood,
Gregory E. Hicks,
B. M. Hobson,
S Holtham,
Carla Hope,
P Hopley,
Tanvir Hossain,
Sina Hossaini,
Frances Howse,
T Hubbard,
Alexandra Humphreys,
H Ikram,
M Ioannis,
Muhammad Javed Iqbal,
Nayyer Iqbal,
Ritu Jain,
Jignesh Jatania,
P Jenkinson,
S Jokhan,
A. Jones,
Carolyn Jones,
Louise Jones,
Heman Joshi,
K Joshi,
Michael Joy,
P Jull,
G Kakaniaris,
R Kallam,
Erica D. Kane,
P Kang,
Rohini Kanitkar,
Samina Kauser,
Farasat Kazmi,
Martha S. Kedrzycki,
Sarah Kelly,
Jason Kendall,
Misbah Khan,
T Khan,
Gentry Teng King,
A Kisiel,
Christos Kitsis,
IK Kolawole,
S Korambayil,
S Kosasih,
Angeliki Kosti,
Ahmed Kotb,
S. Kouris,
K Kshatriya,
S Kumar,
Gloria Inés Lafaurie,
R Lal,
A Lau,
T Lazim,
Antonio Lazzaro,
K Lee,
Rebecca Lefroy,
D Leinhardt,
Hannah Len,
Kai’En Leong,
Bruce D. Levy,
Eric Lim,
J Lim,
S. Lindley,
D Liu,
P Lloyd,
Dafydd Locker,
Sonia Lockwood,
Christopher F. Lowe,
Jonathan N. Lund,
Raimundas Lunevičius,
Aidan Lunt,
S Lutfi,
Anil Luther,
S Luwemba,
P MahankaliRao,
S. Mahroof,
D Mai,
S Majid,
A Malik,
K. Malik,
K. Mann,
S Mansour,
N Manu,
Rahee Mapara,
Claude Martin,
Jocelyne Martin,
R. H. Martin,
C Mason,
L Massey,
J. Mathias,
Pawan Mathur,
Karen Maude,
D. Ray McArthur,
Stephen McCain,
Simon McCluney,
Malcolm McFall,
B McIlroy,
S McKay,
N McKinley,
Angus McNair,
Derek McWhirter,
Peter Mekhail,
Katie Mellor,
James A. Merchant,
Louise Merker,
David E. Messenger,
Alexander Miles,
S Mir,
Anupam Mishra,
P Mistry,
V Miu,
M Moat,
Katherine Mockford,
E. Mohamed,
I. Mohamed,
M MondragonPritchard,
N. Moore,
L. Moretti,
H Morris,
Timothy SeayMorrison,
Victoria Morrison-Jones,
J Moss,
Susan Moug,
D Mountford,
Ray Moynihan,
K Muhammad,
D MuldoonSmith,
John Mulholland,
Michelle Mullan,
Ellen Murgitroyd,
Kavipriya Murugaiyan,
Abigail Kate Myers,
Ioannis Mykoniatis,
G Nana,
T. Nash,
Anwar H. Nassar,
R. W. Newton,
Chin K. Ng,
Pamela Ng,
Khang D. Nguyen,
F. G. Nicholas,
Mohammad Noor,
Jennifer Nowers,
Clare Nugent,
Andrew M. Nunn,
Rebecca Nunn,
Nicole Obeid,
John M. O’Callaghan,
R O'Hara,
Oluchi Oke,
James Olivier,
A O’Neill,
Stephen O’Neill,
Daniel OseiBordom,
L. Osgood,
Spyros Panagiotopoulos,
B Panchasara,
R.W. Parks,
Hiten D. Patel,
Pooja Patel,
R Patel,
Saavan Patel,
Krystian Pawelec,
Cathy Payne,
Kristina K. Pearson,
Giordano Perin,
I Peristerakis,
Barbara Petronio,
L Phelan,
Jonathan Phillips,
C Pisaneschi,
J Pitt,
K PlunkettReed,
Luca Ponchietti,
A Pouzi,
M Pouzi,
Anathea C. Powell,
Anna Powell–Chandler,
N Pranesh,
VK Proctor,
Sarah Pywell,
Adnan I. Qureshi,
Nabeel Qureshi,
MM Rahman,
Z Rai,
S Ramcharan,
Karan Rangarajan,
Madeeha Rashid,
Harriet Reader,
Abdul Rehman,
S Rehman,
C Rengifo,
E. Richards,
Neil Richardson,
Alex P. G. Robinson,
D. Robinson,
Barbara Rossi,
F Rutherford,
Iannish Sadien,
Tahir Saghir,
Kapil Sahnan,
G Salahia,
J Sarveswaran,
M. Saunders,
Bart L. Scott,
Kelly Scott,
Andrew Seager,
Stella Seal,
E Sezen,
Fadlo Shaban,
P Shah,
Palak Shah,
Amira Shamsiddinova,
S Shankar,
A Sharpe,
Veeranna Shatkar,
Andrea Sheel,
T Shields,
Michael Shinkwin,
Jack Shurmer,
Arifa Siddika,
S Siddiqui,
R Simson,
Peter M. Sinclair,
Balaji Singh,
Siddhartha Singh,
Jayaram Sivaraj,
Paul Skaife,
Michael E. Kelly,
Asheley Cockrell Skinner,
N. Slim,
Christopher J. Smart,
Neil Smart,
Fiona Smith,
Ian F. C. Smith,
Daron Smith,
Gavin Spence,
Arsha Sreedhar,
J Steinke,
L Stevenson,
Emma Stewart-Parker,
Martyn Stott,
Brendon Stubbs,
N Stylianides,
Sriram Subramonia,
M Swinkin,
M Swinscoe,
Nicholas Symons,
Warda Tahir,
Tahir Taj,
Katalin Takács,
J. Tam,
Kelvin Bryan Tan,
S Tani,
Nichole T. Tanner,
Dan Tao,
Maxwell D. Taylor,
B Thava,
K Thippeswamy,
Christophe Thomas,
E Thompson,
Richard E. Thompson,
C ThompsonReil,
C Thorn,
F. Tongo,
Gábor Tóth,
A Turnbull,
Jennifer Turnbull,
Carmen Valero,
Gijs van Boxel,
M Varcada,
Mary L Venn,
Nicholas T. Ventham,
Marco Venza,
Dale Vimalachandran,
Ioannis Virlos,
Wade Tp,
Arsalan Wafi,
Kathryn Waite,
Morgan Walker,
N Walker,
T.G. Walker,
Una Walsh,
Stacy Wardle,
R Warner,
J Watfah,
Nora L. Watson,
J W H Watt,
J Watts,
J Wayman,
C Weegenaar,
Hannah D. West,
Malcolm West,
Lauren N. Whitehurst,
M Whyler,
M Wiggans,
Sanjaya Wijeyekoon,
G. Williams,
R Williams,
Andrew Williamson,
J Williamson,
John L. Wilson,
Anke Winter,
Lewis Wolpert,
J Wong,
Evie Yeap,
T Yeong,
S Zaman,
B Zappa,
Dimitrios Zosimas
Publication year - 2020
Publication title -
bjs open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.974
H-Index - 9
ISSN - 2474-9842
DOI - 10.1002/bjs5.50315
Subject(s) - medicine , bowel obstruction , hernia , incisional hernia , groin , bowel resection , surgery , abdominal wall , general surgery , mortality rate
Background Abdominal wall hernia is a common surgical condition. Patients may present in an emergency with bowel obstruction, incarceration or strangulation. Small bowel obstruction (SBO) is a serious surgical condition associated with significant morbidity. The aim of this study was to describe current management and outcomes of patients with obstructed hernia in the UK as identified in the National Audit of Small Bowel Obstruction (NASBO). Methods NASBO collated data on adults treated for SBO at 131 UK hospitals between January and March 2017. Those with obstruction due to abdominal wall hernia were included in this study. Demographics, co‐morbidity, imaging, operative treatment, and in‐hospital outcomes were recorded. Modelling for factors associated with mortality and complications was undertaken using Cox proportional hazards and multivariable regression modelling. Results NASBO included 2341 patients, of whom 415 (17·7 per cent) had SBO due to hernia. Surgery was performed in 312 (75·2 per cent) of the 415 patients; small bowel resection was required in 198 (63·5 per cent) of these operations. Non‐operative management was reported in 35 (54 per cent) of 65 patients with a parastomal hernia and in 34 (32·1 per cent) of 106 patients with an incisional hernia. The in‐hospital mortality rate was 9·4 per cent (39 of 415), and was highest in patients with a groin hernia (11·1 per cent, 17 of 153). Complications were common, including lower respiratory tract infection in 16·3 per cent of patients with a groin hernia. Increased age was associated with an increased risk of death (hazard ratio 1·05, 95 per cent c.i. 1·01 to 1·10; P = 0·009) and complications (odds ratio 1·05, 95 per cent c.i. 1·02 to 1·09; P = 0·001). Conclusion NASBO has highlighted poor outcomes for patients with SBO due to hernia, highlighting the need for quality improvement initiatives in this group.
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