Inguinal Hernia Repair on Day Care Basis During Global COVID-19 Pandemic

  • Syed Fahd Shah Federal General Hospital
  • Zahid Mehmood Minhas Rawalpindi Medical University
  • Malik Jawad Faisal Pakistan Institute of Medical Sciences, Islamabad
  • Syed Hussain Shah CMH, Lahore
  • Syed Zubair Shah PNS, Shifa Karachi
Keywords: Inguinal Hernia, COVID-19, Local Anaesthesia

Abstract

 

Abstract

Background: COVID-19 has effected General Surgical Elective list and most of the surgical procedures are postpone. Inguinal hernia surgery can be performed under local anesthesia on day care basis in selected group of patients taking all necessary precautions for COVID-19.

Patients & Methods: This prospective study was conducted at department of General Surgery Federal Hospital, Islamabad for a period of three months from 15th March 2020 to 15th June 2020. All patients were included in the study through purposive sampling and preference was given to patients elder than 50 years of age. This study included 59 adult patients with inguinal hernia who under mesh repair under local anaesthesia on day care basis.

Results: A total of 59 patients were included in the study. All patients were male. The age range was from 37 to 82 years (SD=± 10.23).  30 (50.84%) patient had inguinal hernia on left side while 26 (44.06%) had hernia on right side. Mean Operative time was 35 min. Pain was chief complaint postoperatively 30 (50.8%) patients had moderate pain while 6 (10.1%) patients had severe pain in first 24 hours after surgery. Fever was present in 15 (25.42%) patients in first 24 hours. All patients were negative for COVID -19 preoperatively and after 2 weeks none of the patients develop any symptoms of COVID-19. 3 (5.08%) patients needed readmission within 24 hours for pain and some haemorrhage. There was no mortality in our study

Conclusions: Inguinal Hernia Surgery under local anaesthesia on day care basis in a very good practice at this time of global pandemic of COVID-19. This is a safe and reliable strategy.

Key words: Inguinal Hernia, COVID-19, Local Anaesthesia

 

References

1. Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version) Mil Med Res. 2020;7(1):4.
2. Li J., Wang Y., Gilmour S., Wang M., Yoneoka D., Wang Y., et al. (2020). Estimation of the epidemic properties of the 2019 novel coronavirus: a mathematical modeling study. medRxiv 2020.2002.2018.20024315.
3. Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 Transmission in Patients With Cancer at a Tertiary Care Hospital in Wuhan, China. JAMA Oncol. 2020; e200980. doi: 10.1001/jamaoncol.2020.0980.
4. Cho SY, Kang JM, Ha YE, Park GE, Lee JY, Ko JH et al MERS‐CoV outbreak following a single patient exposure in an emergency room in South Korea: an epidemiological outbreak study. Lancet 2016; 388: 994–1001.
5. Dalenbäck J, Hjortborg M, Rimbäck G. ABC om - Ljumskbråck hos vuxna [Inguinal hernia in adults]. Lakartidningen. 2016;113:DUEY.
6. Metzger J. Asymptomatische Inguinalhernie: Ist eine Operation überhaupt nötig? [Is the presence of an asymptomatic inguinal hernia enough to justify repair?]. Praxis (Bern 1994). 2015; 104(23):1259-1263. doi:10.1024/1661-8157/a002177.
7. Palumbo P, Amatucci C, Perotti B, Zullino A, Dezzi C, Illuminati G, Vietri F. Outpatient repair for inguinal hernia in elderly patients: Still a challenge? Int J Surg. 2014;12
8. Shah SF, Hameed S, Aurakzai JK, Chaudhary MA, Shah SH, Shah SZ. Chronic Pain after Liechtenstein Mesh Repair for Inguinal Hernia: A review of 114 patients. RMJ.2015: 40(4): 388-91.
9. Hui DS, Azhar EI, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - the latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264–266
10. Bai Y., Yao L., Wei T., Tian F., Jin D. Y., Chen L., et al. . (2020). Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 323, 1406–1407.
11. Chang D., Lin M., Wei L., Xie L., Zhu G., Dela Cruz C. S., et al. . (2020). Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China. JAMA 323, 1092–1093. 10.1001/jama.2020.
12. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y., et al. . (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395, 507–513.
13. Saglietto A., D'Ascenzo F., Zoccai G.B., De Ferrari G.M. COVID-19 in Europe: the Italian lesson. Lancet. 2020;395:1110–1111.
14. Atalan A. Is the lockdown important to prevent the COVID-9 pandemic? Effects on psychology, environment and economy-perspective. Ann Med Surg (Lond). 2020;56:38-42.
15. Nicola M., Alsafi Z., Sohrabi C., Kerwan A., Al-Jabir A., Iosifidis C., Agha M., Agha R. The socio-economic implications of the coronavirus and COVID-19 pandemic: a review. Int. J. Surg. 2020;78:185–193.
16. Diaz A, Sarac BA, Schoenbrunner AR, Janis JE, Pawlik TM. Elective surgery in the time of COVID-19. Am J Surg. 2020;219(6):900-902.
17. Alemanno G, Tomaiuolo M, Peris A, Batacchi S, Nozzoli C, Prosperi P. Surgical perspectives and patways in an emergency department during the COVID-19 pandemic. Am J Surg. 2020;220(1):50-52
18. Reznik A, Gritsenko V, Konstantinov V, Khamenka N, Isralowitz R. COVID-19 Fear in Eastern Europe: Validation of the Fear of COVID-19 Scale [published online ahead of print, 2020 May 12]. Int J Ment Health Addict. 2020;1-6.
19. Pertile D, Gallo G, Barra F, et al. The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic Young Surgeons Society (SPIGC). Updates Surg. 2020;72(2):269-280.
20. Metzger J. Asymptomatische Inguinalhernie: Ist eine Operation überhaupt nötig? [Is the presence of an asymptomatic inguinal hernia enough to justify repair?]. Praxis (Bern 1994). 2015;104(23):1259-1263.
21. Gong W, Li J. Operation versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias: The meta-analysis results of randomized controlled trials. Int J Surg. 2018;52:120-125.
22. de Goede B, Wijsmuller AR, van Ramshorst GH, et al. Watchful Waiting Versus Surgery of Mildly Symptomatic or Asymptomatic Inguinal Hernia in Men Aged 50 Years and Older: A Randomized Controlled Trial. Ann Surg. 2018;267(1):42-49
23. Tao KX, Zhang BX, Zhang P, Zhu P, Wang GB, Chen XP; General Surgery Branch of Hubei Medical Association, General Surgery Branch of Wuhan Medical Association. Recommendations for general surgery clinical practice in 2019 coronavirus disease situation. Zhonghua Wai Ke Za Zhi. 2020;58(3):170-7.
24. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343-403.
25. Palumbo P, Amatucci C, Perotti B, et al. Outpatient repair for inguinal hernia in elderly patients: still a challenge?. Int J Surg. 2014;12 Suppl 2:S4-S7.
26. Bourgon AL, Fox JP, Saxe JM, Woods RJ. Outcomes and charges associated with outpatient inguinal hernia repair according to method of anesthesia and surgical approach. Am J Surg. 2015;209(3):468-472.
27. Raiss H, Hübner M, Abrazhda D, Demartines N, Vuilleumier H. Cure de hernie inguinale en ambulatoire [Outpatient hernia surgery]. Rev Med Suisse. 2011;7(300):1354-1356.
28. Palumbo P, Usai S, Amatucci C, et al. Inguinal hernia repair in day surgery: the role of MAC (Monitored Anesthesia Care) with remifentanil. G Chir. 2017;38(6):273-279.
Published
2021-12-31
How to Cite
1.
Shah S, Minhas Z, Faisal M, Shah S, Shah S. Inguinal Hernia Repair on Day Care Basis During Global COVID-19 Pandemic. JRMC [Internet]. 31Dec.2021 [cited 21Jan.2022];25(4). Available from: https://journalrmc.com/index.php/JRMC/article/view/1715

Most read articles by the same author(s)