Early post-operative complications and factors influencing their outcome, following inguinal hernia repair as seen at Kenyatta national hospital

Abstract

Complications after inguinal hernia repair are relatively common, whose incidence is higher after emergency and recurrent hernia repairs compared with elective repair. With the transition to tension-free repair, hernia recurrence is less frequent while other complications, such as post-herniorraphy neuralgia, have become more prominent. In our local set-up, these hernia repairs are done by residents at various levels of training and consultant surgeons depending on the complexity of the case. Local data on disease burden and post-operative complications has not been updated. Objective The main objective of the study determined the early post-operative complications and factors influencing their outcome in patients that underwent inguinal hernia repair at Kenyatta National hospital. Study Design A prospective non-randomized descriptive study. Study Duration The study was conducted over a period of 8 months from March 2016 to November 2016. Materials and Methods The study incorporated patients above the age of 12 years admitted to surgical wards for both emergency and elective inguinal hernia repair at KNH main theatres during the period under study. Consenting clients were followed up post-operatively for a 30 day period. Surgical outpatient clinic reviews and phone-calls were utilized during this period for follow-up of patients discharged from the wards post-operatively. A questionnaire designed for this study was used for data collection, involving the age, sex, occupation, type of hernia, mode of presentation, type of anesthesia, type of surgery, type of herniorraphy, experience level of the surgeon, and use of peri-operative prophylactic antibiotics. Wounds were exposed on the third post-operative day and inspected for any complications. Early complications were considered as: hematoma/seroma formation, morbidity and mortality, scrotal swelling, numbness, recurrence and wound infections. Data were collected using a predesigned questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) for windows version 21.Data were analyzed by means, median, mode, and standard deviation and subjected to univariate or multivariate analysis for multiple outcomes. Parametric data were analyzed using the paired T-test, while non-parametric data were analyzed using Wilcoxon signed-ranked test.