This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Population‐based study of presentation and adverse outcomes after femoral hernia surgery. BJS 2013; 100: 1827-1832.

Published: 14th November 2013

Authors: D. J. Humes, R. S. Radcliffe, C. Camm, J. West

Background

Rates of emergency admission with femoral hernia are high compared with those for other hernias. This study aimed to determine the modes and consequences of presentation to primary care before admission to hospital.

Method

This was a population‐based cohort study using healthcare records from the Clinical Practice Research Datalink linked to Hospital Episode Statistics data from 1997 to 2007. Length of hospital stay, bowel resection rates and 30‐day mortality were calculated.

Results

A total of 885 patients (690 female, 78.0 per cent) underwent femoral hernia repair, with 406 operations (45·9 per cent) performed as an emergency. The majority of patients who were admitted as an emergency (331, 81·5 per cent) presented to the general practitioner for the first time with symptoms of a hernia in the 7 days before admission, compared with just ten (2·1 per cent) of 479 patients admitted electively (P < 0·001). The median (i.q.r.) length of stay for patients undergoing elective surgery was 1 (0–2) day compared with 5 (3–9) days for those having an emergency repair (P < 0·001). Adverse events were more common among patients operated on as emergency, with 94 (23·2 per cent) having a small bowel resection compared with one (0·2 per cent) who had elective surgery. There were no deaths within 30 days in the elective group, but seven (1·7 per cent) in the emergency group.

Conclusion

A large proportion of patients with femoral hernia present late to primary care and are operated on as an emergency, with worse outcomes.

Full text

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Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.

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Original article

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.

Authors: N. Patel, R. J. Egan, B. R. Carter, D. M. Scott‐Coombes, M. J. Stechman, A. Afzaal et al.

Population‐based study of presentation and adverse outcomes after femoral hernia surgery. BJS 2013; 100: 1827-1832.

Background

Method

Results

Conclusion

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