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Outpatient uncomplicated inguinal hernia repair versus in-hospital procedure-analysis of 148 cases

Roman Krupiński, Jerzy Narębski,, Lech Pomorski, Magdalena Bartos

Med Sci Monit 1997; 3(2): CR213-216

ID: 500700

Published: 1997-03-03

In the years 1994-1995, 148 patients were operated on for inguinal hernia, including 136 (91.9%) males and 12 (8.1%) females. The age of the patients ranged from 18 to 64 years (average 47 years). 99 (79.5%) oblique and 49 (20.5%) direct hernias were found intraoperatively. After intramuscular premedication with the use of pethidine, promethazine and atropine, the patients were operated on under local anaesthesia (0.5% lidocaine). 92 (62%) patients underwent the Bassini operation and in 56 (38%) the Shouldice herniorrhaphy was used. Out of 148 patients, in 112 (75.7%) an outpatient procedure was applied, and 36 (24.3%) were hospitalized during a few days.In the outpatients, preoperative investigations were conducted in ambulatory departments. The patients were admitted to the Clinic in the morning, operated on in the afternoon and discharged in 4-8 hours (median 6 hours) after the procedure. The patients were followed up in outpatient departments.Among all outpatients, 2 (1.8%) developed ecchymosis, 3 (2.8%) experienced scrotum oedema, and in one (0.9%) wound infection occurred. Over the follow-up period ranging from 6 to 24 months no hernia recurred. There were no significant differences between the incidence rates of early and late complications in both groups of the patients. 97.3% of outpatients accepted outpatient herniorrhaphy, while only 61.1% of inpatients accepted an in-hospital procedure. The costs of outpatient hernia repair were several times lower than the costs of inpatient surgery.Conclusion: Outpatient repairs of uncomplicated inguinal hernia are as safe and effective as herniorrhaphy with a several-day hospitalisation period.

Keywords: herniorrhaphy, outpatient hernia repair, inguinal hernia