Inguinal hernia repair: are the results from a general hospital comparable to those from dedicated hernia centres?
BACKGROUND
We aimed to report the outcomes of inguinal hernia repair performed at Tan Tock Seng Hospital and compare them with those performed at dedicated hernia centres.


METHODS
We retrospectively analysed the medical records and telephone interviews of 520 patients who underwent inguinal hernia repair in 2010.


RESULTS
The majority of the patients were male (498 [95.8%] men vs. 22 [4.2%] women). The mean age was 59.9 ± 15.7 years. Most patients (n = 445, 85.6%) had unilateral hernias (25.8% direct, 64.3% indirect, 9.9% pantaloon). The overall recurrence rate was 3.8%, with a mean time to recurrence of 12.0 ± 8.6 months. Risk factors for recurrence included contaminated wounds (odds ratio [OR] 50.325; p = 0.004), female gender (OR 8.757; p = 0.003) and pantaloon hernias (OR 5.059; p = 0.013). Complication rates were as follows: chronic pain syndrome (1.2%), hypoaesthesia (5.2%), wound dehiscence (0.4%), infection (0.6%), haematoma/seroma (4.8%), urinary retention (1.3%) and intraoperative visceral injury (0.6%). Most procedures were open repairs (67.7%), and laparoscopic repair constituted 32.3% of all the inguinal hernia repairs. Open repairs resulted in longer operating times than laparoscopic repairs (86.6 mins vs. 71.6 mins; p < 0.001), longer hospital stays (2.7 days vs. 0.7 days; p = 0.020) and a higher incidence of post-repair hypoaesthesia (6.8% vs. 1.8%; p = 0.018). However, there were no significant differences in recurrence or other complications between open and laparoscopic repair.


CONCLUSIONS
A general hospital with strict protocols and teaching methodologies can achieve inguinal hernia repair outcomes comparable to those of dedicated hernia centres.
Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. kaixiong.cheong@mohh.com.sg.
Kai Xiong
KX
Cheong
Hong Yee
HY
Lo
Jun Xiang Andy
JX
Neo
Vijayan
V
Appasamy
Ming Terk
MT
Chiu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods* / Q000592:standards; D006769:Hospitals, General / Q000458:organization & administration*; D006782:Hospitals, Special / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012846:Singapore; D016896:Treatment Outcome; D055815:Young Adult