Retrospective Study on Prevalence of Primary and Recurrent Inguinal Hernia and its Repairs in Patients Admitted to a Tertiary Care Hospital.

ABSTRACT

A total of 498 cases were followed up from the past 5 years data from hospital records to evaluate several aspects of Recurrence of Inguinal hernia and its repair in Medical College, Kolkata. The data included type of hernia, primary or recurrent hernia, year of primary operation, primary and recurrent operation type, nature of mesh used, years to recurrence, presence of risk factors. Inguinal hernia recurrence is found among 153 (30.72%) cases, with a male preponderance of primary hernia with considerable recurrence in female too. The left sided and indirect hernias seemed to be more prevalent than others. Early recurrence (37.91%) represented predominantly technical failures of the operative procedure and selection of patients. Both primary and recurrent hernias were found predominantly in the middle aged persons. An increase in incidence of primary and recurrent hernias was seen with advancement of time. The usual techniques that are implemented in repair of inguinal hernia were mostly the Laparoscopic technique (36.23%) and also Lichtenstein Repair in recurrent hernia cases (58.82%) with the use of Polypropelene mesh. Shouldice repair and Modified Bassini’s techniques are implemented in very few cases. Smoking, Chronic Obstructive Pulmonary Diseases, Chronic Constipation, Diabetes and Benign Hypertrophy of Prostate were found to be the prominent risk factors in precipitating recurrence of inguinal hernia. The study points to the loop holes in the hospital’s strategy, to tackle with a case of inguinal hernia, which are necessary to be removed, in order to curb the morbidity of the patient and hospital management, by the overwhelming patient load.