Clinical and surgical epidemiological analysis after bilateral herniorrhaphy

Abstract

Introduction: Inguinal hernia is an anatomical defect resulting from evagination of intra-abdominal structures into inguinal canal. In bilateral cases, the surgical approach depends on the extent of the hernia and may be associated with greater relapse rate than that of unilateral repair. Objective: To analyze clinical and surgical epidemiological variables in the postoperative period of patients submitted to bilateral inguinal herniorrhaphy. Methods: Retrospective study of 51 medical records of patients submitted to bilateral inguinal herniorrhaphy at Hospital Estadual João Paulo II de São José do Rio Preto (SP) from 2006 to 2016. Results: Patients had mean age of 51.6 years, were most male (84%), whites (86.36%), smokers (62.86%), and farmers (21.43%). In 100% of cases, spinal anesthesia and use of tension-free technique (Lichtenstein) were performed, with in-hospital stay ranging from 1 to 4 days. During an average of 4 years of postoperative follow-up, there were no complications in 43 patients (84.31%); unilateral relapse occurred in 7.84%, and seroma in 3.92%. Average time to return to post-surgery activities was 58 days. There was significant association between inguinal hernia and male gender, Caucasian race, occupation as farmer and smoking; but no associations with periods of hospitalization, return to daily activities and postoperative follow-up. Conclusion: Bilateral inguinal hernia tends to affect white middle-aged men, smokers and with intense physical labor. Spinal anesthesia and surgical technique of Lichtenstein have been widely accepted as treatment approach. Although unilateral relapse may be present, it is associated with intrinsic factors or surgical intercurrences. Bilateral repair of inguinal hernia presents no morbidity greater than unilateral correction, and return to daily activities tends to be similar.