Acute postoperative complications increase the risk of recurrence and chronic pain after inguinal hernia surgery: A single-center retrospective analysis

Abstract

AIMS: To investigate the factors associated with recurrence and chronic pain after inguinal hernia surgery. SETTINGS AND DESIGN: A retrospective study was conducted over a period of 3 years and 5 months. MATERIALS AND METHODS: All patients over the age of 15 who underwent surgery for an inguinal hernia were included. STATISTICAL ANALYSIS USED: Factors associated with recurrence and chronic pain were evaluated using the Kaplan–Meier method and multivariate Cox proportional hazard model. RESULTS: During the study period, 195 patient records were collected. According to the European Hernia Society classification, 75.9% (n = 148) of hernias were lateral, and 24.1% (n = 47) were medial. The hernia was primary in 92.3% (n = 180) of cases and recurrent in 7.7% (n = 15). The hernia was strangulated in 29.7% (n = 58) of cases. The surgical techniques used were: Bassini in 64.6% (n = 126) of cases, Desarda in 23.6% (n = 46), Lichtenstein in 9.7%, Mc Vay in two cases (1%) and trans-abdominal pre-peritoneal (TAPP) in two cases (1%). Acute postoperative complications were observed in 18 cases (9.2%). The average follow-up period was 25.4 months, with a range of 3–62.8 months. Chronic pain was observed in 18 cases (9.2%) and recurrence in 11 cases (5.6%). Multivariate analysis identified several prognostic factors, including recurrence (the existence of acute postoperative complications, P = 0.041); for chronic pain (a work with physical effort, P = 0.04; the existence of acute postoperative complications, P = 0.001, and mesh repair, P = 0.04). CONCLUSIONS: Our findings suggest that the management of acute complications, such as seroma, hematoma, and infection, is crucial to minimize the risk of long-term complications.

Keywords

• africa
• chronic pain
• hernia
• mesh
• recurrence
• surgery