[Inguinal tension-free hernioplasty performed by day-care surgery in a non-specialized hospital].
BACKGROUND
At present, as a result of the introduction of tension-free techniques, the general opinion is that the treatment of inguinal hernia needs day-care surgery. Nevertheless day-care surgery requires a specific organization of the hospital and of the territorial services, after the discharge of the patient. These facilities are not always available all over the country. The aim of this paper is to present the results of the treatment of inguinal hernia performed by day-care surgery in an unspecialized hospital.


METHODS
From April 1999 to April 2000, 28 patients (25 M), median age 54 years (range 25-85), affected by inguinal hernia, underwent ernioplasty operation according to Trabucco technique, by only one skilled surgeon, in an unspecialized hospital. Five patients were affected by inguinal hernia of type I of Nyhus, 9 of type II, 10 of type IIIa and 4 of type IIIb. Twenty-five patients underwent spinal anaesthesia and 3 general anaesthesia due to failure of the previous one or for contraindications due to spine diseases or due to patient's request. All patients remained in the hospital the night after the operation. After discharge, patients were controlled in the outpatient ambulatory every other day for 10 days. After that, patients were required to submit to physical examination only if they were symptomatic. At present, average follow-up is of 18.1+/-6.3 months.


RESULTS
The following unspecific complications prevalently due to spinal anaesthesia were observed: 2 (7.1%) acute urinary retentions, 1 (3.6%) headache, 1 (3.6%) acute hypotension, 2 (7.1%) feverets, 1 (3.6%) vomiting, and 1 (3.6%) influenza. The specific complications were: 2 (7.1%) transient neuralgias, 2 (7.1%) ecchimosis and 1 (3.6%) infection of the wound. Average intensity of postoperative pain (VAS) was of 2.8+/-1.2. The average abstention from work was of 12.5 days. Until now, any recurrence has been observed.


CONCLUSIONS
In spite of the few cases, our results are similar to those of specialized hospitals organized for day-care surgery. Anyway, in the management of these patients in unspecialized hospitals, according to our opinion one night in the hospital after the operation is required for the easiness of the patient and of the surgeon.
Salamina
G
G
Dipartimento di Chirurgia, IRCCS Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Agostini
M
M
Venturi
M
M
Pericolo
T
T
Valenghi
D
D
Boccasanta
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods
Ernioplastica inguinale tension-free praticata in regime di Day Surgery in un ospedale non dedicato.