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Volume 12 Issue 3 ( July-September ) 2023

Original Articles

Risk Factors of Postoperative Complications After Emergency Inguinal Hernia Surgery
Dr. Sandeep Sharma, Dr. Rakesh Shakya, Dr. Vishnu Gupta, Dr.Anand Rajput

Background: Complications after inguinal or femoral hernia repair are relatively common. Complications that occur in the perioperative period were wound seroma/hematoma, urinary retention, and superficial incisional surgical site infection, while complications that occur later following hernia repair include persistent groin pain, sexual dysfunction, deep incisional/mesh infection, recurrent hernia, and mesh migration and erosion Aim & Objective: This study aimed to explore the risk factors of postoperative complications for adult patients with Incarcerated groin hernia (IGH). Material & Methods: this was a retrospective study carried out in the department of the surgery in a tertiary care hospital, central India. Patients undergoing emergency hernia repair for Incarcerated groin hernia (IGH) during the study period were included in our study. Socio-demographic data were collected from all the patients. Postoperative complications, such as surgical site infection, seroma, hernia recurrence and mortality, were investigated, with risk factors for such complications were analyzed. Results: Sixty-four patients were included, with 51 males and 13 females (mean age 65.1, range 25–98 years). Ten patients (15.6%) underwent resection of necrotic bowel and anastomosis. 43 patients (67.2%) received open tension-free herniorrhaphy with polypropylene mesh, whereas the rest (32.8%) received herniorrhaphy without mesh. The overall postoperative complication rate was 40.6% (26/64), with an incisional complication rate of 31.2% (20/64) and an infection rate of 6.2% (4/64). At a median follow-up of 32 months, hernia recurrence and mortality were recorded in five cases each (7.8%). Mesh repair was associated with decreased recurrence rate compared with non-mesh repair (2.3% vs. 19.0%, p = 0.019). Diabetes mellitus (OR 8.611, 95%CI 1.292–57.405; p = 0.026) was an independent risk factor of postoperative complications, together with chronic obstructive pulmonary disease (COPD; OR 14.365, 95%CI 1.652–127.767, p = 0.016), intestinal necrosis (OR 14.260, 95%CI 1.079–188.460, p = 0.044), and general anesthesia (OR 14.543, 95%CI 1.682–125.711, p = 0.015) as risk for incisional complications after surgery. Conclusion: Diabetes mellitus was an independent risk factor of postoperative complications for IGH, along with COPD, intestinal necrosis and general anesthesia associated with incisional complications. The use of polypropylene mesh did not increase infection or recurrence rate in this cohort. Keywords: Incarcerated groin hernia (IGH), Risk factors, Complications, herniorrhaphy

 
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