INGUINAL HERNIOPLASTY: DAY SURGERY OR HOSPITAL SURGERY PROCEDURE
Anko Antabak, Ivana Bešlić, Krešimir Bulić, Mate Škegro, Dino Papeš, Miram Pasini, Marko Bogović, Stanko Ćavar, Tomislav Luetić
Inguinal hernia repair is a surgical procedure that can be done in inpatient or one-day surgery. Adequate patient selection is not a simple task. There are more than several selection criteria, but the main objective is a patient safety. This study analyzes the patient selection criteria and compares safety in the manner of postoperative complications between the two groups of patients. There were 590 patients who underwent surgical repair of inguinal hernia at the University Hospital Centre Zagreb in 2015. 226 (38.3%) of them were treated in one-day surgery, and 364 (61.7%) were treated at the main Surgical department; 69 of those had an emergent presentation. Most patients of child age (0–18) were treated at the inpatient department. Patients in the age groups between 19 and 39 years, as well as those between 35 and 49 were dominantly managed at the Department of one-day surgery. Those patients were mainly ASA I and ASA II (only three of them were ASA III), while hospitalized patients were mostly ASA II (52.2%). In the hospitalized, inpatient group, frequency of ASA I was 24%, ASA II 21% and ASA IV 3%. The greatest number of one-day surgery patients underwent surgery under local anesthesia (68%). In contrast, only 8% of the inpatient group had a surgery under local anesthesia. The percentage of patients with postoperative wound infection was 2%, and the incidence of pain after surgery was 8%. The results didn’t statistically differ between the groups. The recurrence rate was slightly more frequent in the inpatient group. Hematomas and seromas had the same incidence pattern; they were rarely present and without differences between the groups. 7 of 226 ambulatory patients (3%) were hospitalized. The main causes for three of them were nausea, weakness and hypotension; two patients had tachycardia and stenocardia, one patient had neurasthenia, and also one had scrotal hematoma. The hernia repair in both groups was associated with low postoperative complications, low recurrence rate, and low percentage of unplanned hospital admissions. Therefore it is considered that both groups were treated in a safe manner and patient selection was adequate.