Format

Send to

Choose Destination
Hernia. 2018 Jun;22(3):427-435. doi: 10.1007/s10029-017-1689-5. Epub 2017 Oct 27.

Outpatient groin hernia repair: assessment of 9330 patients from the French "Club Hernie" database.

Author information

1
Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Hôtel Dieu, CHU Nantes, Place Ricordeau, 44093, Nantes Cedex 1, France. farouk.drissi@gmail.com.
2
Chirurgie générale et Digestive, Clinique Mutualiste de l'Estuaire, Cité sanitaire, 11 boulevard Georges Charpak, 44606, Saint Nazaire, France.
3
Chirurgie Générale et Digestive, CMC Georges Bizet, 23 rue Georges Bizet, 75116, Paris, France.
4
Unité de Chirurgie Viscérale et Digestive, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160, Antony, France.
5
EA 4725 SPHERE « methodS in Patient-centered outcomes & HEalth ResEarch » , Université de Nantes, Nantes, France.
6
Plateforme de Biométrie, Département Promotion de la Recherche Clinique, CHU Nantes, Nantes, France.

Abstract

BACKGROUND:

Groin hernia repair (GHR) is one of the most frequent surgical interventions practiced worldwide. Outpatient surgery for GHR is known to be safe and effective.

AIM:

To assess the outpatient practice for GHR in France and identify predictive factors of failure.

METHOD:

Forty one surgeons of the French "Club Hernie" prospectively gathered data concerning successive GHR over a period of 4 years within a multicenter database.

RESULTS:

A total of 9330 patients were operated on during the period of the study. Mean age was 61.8 (1-100) years old and 8245 patients (88.4%) were males. 6974 GHR (74.7%) were performed as outpatient procedures. In 262 patients (3.6%), the outpatient setting, previously selected, did not succeed. Upon multivariate analysis, predictive factors of ambulatory failure were ASA grade ≥ III (OR 0.42, p < 0.001), bilateral GHR (OR 0.47, p < 0.001), emergency surgery for incarcerated hernia (OR 0.10, p < 0.001), spinal anesthesia (OR 0.27, p < 0.001) and occurrence of an early post-operative complication (OR 0.07, p < 0.001). The more frequent complications were acute urinary retention and surgical site collections. 2094 patients (21.5%) were not selected preoperatively for 1-day surgery.

CONCLUSION:

More than 74% of the patients benefited from outpatient surgery for GHR with a poor failure rate. Predictive factors of outpatient GHR failure were ASA grade ≥ III, bilateral GHR, emergency surgery for incarcerated hernia, spinal anesthesia and occurrence of an early post-operative complication. Ambulatory failures were often related to social issues or medical complications. Outpatient surgery criteria could become less restrictive in the future.

KEYWORDS:

Ambulatory; Groin hernia repair; Laparoscopic groin hernia repair; Outpatient

PMID:
29080110
DOI:
10.1007/s10029-017-1689-5

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center