Umblikal Hernili Hastaların Değerlendirilmesi: 6 Yıllık Deneyim

Abstract

Objective: Umbilical hernia is a common anterior abdominal wall defect in childhood. Although the defect is present at birth, unlike other hernias of childhood, it may close spontaneously over time without the need for surgery. However, when these hernias do not close spontaneously, complications can develop that require emergency surgery. The aim of this study was to determine the incidence of spontaneous closure in patients diagnosed with umbilical hernia and the factors that influence this incidence, the complications that may develop during follow-up, the indications for surgery and the issues to consider when planning the follow-up of patients. Material and Methods: Between January 2006 and December 2011, 1928 patients diagnosed with umbilical hernia and followed up and treated in our clinic were included in the study. In this retrospective cohort study the current size of umbilical hernia, comorbidities and demographic characteristics of the patients were analysed. Operative data, complications and postoperative follow-up of the operated patients were evaluated. Results: The spontaneous closure rate of umbilical hernia was found to be 60%. The rate of spontaneous closure of umbilical hernia was higher in boys and the rate of operation was higher in girls. The risk of incarceration was higher in girls than in boys. The rate of spontaneous closure decreased with increasing defect size. It was found that comorbidities did not affect spontaneous closure of umbilical hernias. The rate of emergency surgery for incarceration was low (2%). Strangulation was noted in 1% of patients. All patients with incarceration were in Lassaletta group 2 (defect diameter 0.5-1.5 cm). Conclusion: Conservative management is still the most accepted and safest method in the treatment of umbilical hernia. Incarceration and strangulation are very rare in umbilical hernias. Even if the umbilical hernia is complicated, surgical treatment is possible and peri- and post-operative complication rates are very low. Long-term morbidity and mortality due to incarceration have not been reported in the literature.