Postoperative outcomes following inguinal hernia repair in inflammatory bowel disease patients compared to matched controls

Eur J Gastroenterol Hepatol. 2021 Apr 1;33(4):522-526. doi: 10.1097/MEG.0000000000001936.

Abstract

Objectives: To assess surgical outcome in inflammatory bowel disease (IBD) patients who underwent inguinal hernia repair and to asses possible risk factors.

Methods: A retrospective analysis of a prospective database including all IBD patients treated in a large tertiary center between 2008 and 2019 was conducted. IBD patients who underwent inguinal hernia surgery were matched using a propensity match scoring based on demographic and perioperative characteristics. Clinical operative data were extracted from medical records and analyzed.

Results: Overall, out of 5467 IBD patients treated in our institute, 26 patients (0.47%) underwent inguinal hernia repair. Seventy-six matched patients with similar characteristics were compared to the IBD group. Postoperative complications were found to be more common in the IBD group (30.7% vs 11.8%; P = 0.03) compared to controls. We found no significant differences in length of stay (3.38 vs 2.83 days; P = 0.21) and hernia recurrence rate (7.6% vs 9.2%; P = 1). Within the IBD group, multivariate analysis failed to demonstrate any possible risk factor for postoperative complications, including gender [-1.53 to 2.81 95% confidence interval (CI), P = 0.52], age (-0.34 to 1.15 95% CI, P = 0.25), BMI (-0.041 to 0.019 95% CI, P = 0.43), American Society of Anesthesiologists score (-0.15 to 0.54 95% CI, P = 0.24) or medications (-0.25 to 0.28 95% CI, P = 0.88). In addition, out of various operative factors, including operation urgency, surgical approach and surgery duration, only the latter was found to be correlated with postoperative complications (0.013-0.035 95% CI, P < 0.001).

Conclusion: IBD Patients undergoing abdominal wall hernia surgery are prone to more postoperative complications.

MeSH terms

  • Hernia, Inguinal* / surgery
  • Herniorrhaphy / adverse effects
  • Humans
  • Inflammatory Bowel Diseases* / surgery
  • Laparoscopy*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome