Clinicoepidemiologic profile of inguinal hernia in rural medical college in central India

Rao, Sruthi; Singh, Prashant; Gupta, Dilip; Narang, Ravinder

doi:10.4103/0971-9903.189543

Cited by 14 publications

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“…Literature quotes the mean age of inguinal hernia to be 40 to 60 years. 3 Our experience was similar, and this age group leads to an economic burden on account of the productive age group being affected. In all age groups, males were more affected.…”

Section: Discussionmentioning

confidence: 59%

“…Factors responsible in males are strenuous activities, chronic cough, and preformed sacs. [3][4][5] Even males tend to present late due to their fear of surgery and loss at work, causing financial burden on the family. These factors were comparable to other developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] The most common surgical procedure opted for was Lichtenstein's mesh repair technique, which is the simplest and has the advantage of being an open, tension-free repair with the least rates of recurrence. 3,9,10 For children, the choice was herniotomy with minimal postoperative complications. We performed laparoscopic repairs in 51 (6.25%) patients at our setup.…”

Section: Discussionmentioning

confidence: 99%

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Abdominal Wall Hernias: An Epidemiological Profile and Surgical Experience from a Rural Medical College in Central India

et al. 2021

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Background Abdominal wall hernia is a common surgical entity worldwide with groin hernias having the most common presentation among them. They are a cause of morbidity and mortality if not addressed in time. A variety of surgical methods are available for the repair of hernias. The tension-free repair using synthetic mesh has the least recurrence and is the most accepted. Aim To describe the surgical burden and clinical profile of abdominal wall hernias as well as experiences in their management in a rural setup. Methods This was a retrospective observational study of all the cases of abdominal wall hernias presenting to various surgical divisions of Mahatma Gandhi Institute of Medical Sciences, Sevagram, during a two-year period from December 2011 to November 2013. Relevant details were collected from the hospital information statistics and patient file records and analysis of obtained data was done. Result A total of 910 out of 90,056 surgical outpatients (10.10%) seen during this period had abdominal wall hernias; 816 (89.67%) got operated. A total of 163 (20%) of 816 were operated in an emergency. Groin hernias were the most common 653 (80%), followed by incisional 82 (10%), umbilical and paraumbilical 41 (5%), epigastric 33 (4%), and rarer hernias in 8 (1%). Of 816 operations, 24 (2.9%) had recurrent hernias and 83 (10.17%) were pediatric patients. Male to female ratio was 9:1 in adults and 4:1 in children. The median age among adults was 49 years (range: 14–95 years), and among the pediatric age group, it was 7 years (range: 3 months–14 years). The majority of the adult patients were from a low-income group and presented more than 2 years after symptoms appeared. Comorbid conditions encountered were hypertension in 212 (26%), diabetes in 155 (19%), chronic airway disorders in 449 (55%), cardiac problems in 163 (20%), obesity in 10 (1.2%), and chronic renal failure and liver disorder in 82 (1%). Predisposing factors in the majority of the patients were chronic cough 449 (55%), prostatic problems in 187 (23%), chronic constipation in 163 (20%), previous surgeries in 82 (10%), obesity in 10 (1.2%), and ascites in 9 (0.1%). Hernia surgery was performed laparoscopically in 51 (6.25%) patients. Simultaneous other surgeries were performed in 130 (16%) patients. Mortality occurred in 2 (0.24%) patients operated in emergency, and chief morbidity was due to wound infection in 25 (3%) and chronic pain in 30 (3.9%) patients. Conclusion Abdominal wall hernias are common clinical entities. Although the pattern of presentation and management is similar, the challenges faced in a rural setup are due to ignorance, social inhibitions, and financial restraints, leading to delayed presentations which increase their morbidity and mortality. Health programs and surveys to increase awareness in rural areas as well as cutting down on expenses could help these patients.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Abdominal Wall Hernias: An Epidemiological Profile and Surgical Experience from a Rural Medical College in Central India

et al. 2021

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“…[ Table 3] In another study done in Central India, authors did not found association of increased body mass index with incidence of inguinal hernia in their patient groups. [12] One hypothesis for this phenomenon is that the intraabdominal visceral fat prevents hernia from occurring. Moreover, the clinical diagnosis of inguinal hernia in obese patient is more challenging resulting in lower diagnostic sensitivity.…”

Section: Resultsmentioning

confidence: 99%

Association of Primary Inguinal Hernia with Body Mass Index in Patients of Bundelkhand Region of India

Purohit¹,

Singh²

2018

AIMDR

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Background: Inguinal hernia is a common condition dealt by surgeons in our country. It is said to be asoociated with increasing age, male gender, smoking, connective tissue disorder and factors responsible for increased intraabdominal pressure. Development of inguinal hernia and its relation with body weight is controversial. So present study has been carried to find out relation of body mass index with development of inguinal hernia in both gender, various age groups and its association with type of inguinal hernia. Methods: This was a prospective study carried out on patients of primary inguinal hernia belonging to Bundelkhand region of India. Patients were categorized according to Body Mass Index (BMI) as normal weight (BMI=18.5-24.9), overweight (BMI=25-29.9), class 1 obese (BMI=30-34.9), and morbid obese i.e. class 2 & 3 obese (BMI≥35). Data were further classified in groups formed on the basis of BMI of patient versus age, gender of patients and type of inguinal hernia viz. direct/ indirect hernia. All the findings were tabulated and inferences were drawn followed by statistical comparison with the help of "Statistical Calculator v 4.0" using suitable test viz. chi-square test with p value <0.05 considered as significant. Results: Age groups ranging from 21 years up to 70 years had highest number of patients who were having normal weight (BMI =18.5-24.9). Among the male gender, highest number of patients belonged to BMI group of 18.5-24.9 (i.e. normal weight). Patient group with BMI of ≥ 35 (i.e. class 2 & 3 obese) had the least frequency distribution in males as well as in females. Among the patients of primary direct inguinal hernia and primary indirect inguinal hernia, patient group with BMI of 18.5-24.9 (normal weight) showed highest frequency and patient group with BMI ≥ 35 (class 2 & 3 obese) showed least frequency. Conclusion: Present study shows that in our study population, high Body mass index is not associated with high occurrence of inguinal hernia among the genders and different age groups, rather it seems to be protective for inguinal hernia.

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“…[5][6][7] In an Indian study conducted by Sayanna S et al, found that the proportion of males were 87.88%≈88.0%. 5 Incidences of inguinal hernia both primary and recurrent were found to be roughly 89% in males as reported in a study by Basu I et al,91.8% of males constituted of total patients of inguinal hernia in a study by Rao SS et al 6,7 Numerous repair techniques have been described since Eduardo Bassini published his first successful anatomybased repair in 1890. During the 20th century, the repair trend has changed several times.…”

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A comparative study between open lichtenstein mesh repair and laparoscopic totally extra peritoneal repair of inguinal hernia

et al. 2018

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INTRODUCTIONInguinal hernias constitute the most common form of abdominal wall hernias. The incidence of inguinal hernia remains indefinite; however, nearly about 500,000 cases come to medical attention each year. Twenty or more years ago, international and US surveys were conducted, wherein, the non-surgically treated inguinal hernia prevailed among 5% of men and similarly, same number of men had history of hernia repair.1 The lifetime risk of inguinal hernia is estimated to be 27% and 3% for men and women respectively. Inguinal hernia repair is one of the commonly performed general surgeries among both adults and children accounting for more than 95% of all groin hernia repairs. 3Collective Indian data are limited.4 However in few of the Indian studies, the prevalence of inguinal hernias among ABSTRACT Background: The study was conducted to compare and assess the duration of procedure, complications encountered, post-operative pain and recovery, duration of hospital stay, and time taken in resumption to work between two techniques of open Lichtenstein mesh repair (OLMR) and Totally extra peritoneal (TEP) repair in the low resource settings. Methods: A cross sectional comparative study was conducted among 50 male patients admitted for surgical repair of hernia. After considering the inclusion and exclusion criteria, the subjects were randomly assigned to the groups of OLMR and TEP and were assessed for pain in the post-operative period was rated using a Visual Analogue Scale. Total duration of the procedure, complications, duration of hospital stay, and time taken in resumption to work were elicited between two techniques. A p-value of <0.05 was taken as statistically significant. Results: The mean duration of surgery among the study participants in TEP (49.60+3.62 mins) group was significantly higher compared to OLMR (45.96+4.63 mins) group (p=0.003). The median of post-operative pain scores in TEP group was significantly lower compared to OLMR group. The mean duration of post-operative recovery time (3.08+0.4 days), for resumption to work (5.08+0.28 days) among the study participants in TEP group was significantly lower compared to OLMR (5.00+0.00 days), (10.08+0.76 days) (p<0.001) respectively. The complications were significantly higher among the OLMR group (100.0%) compared to the TEP group (p<0.05). Conclusions: Though the procedure of TEP repair for inguinal hernia takes a little longer time and complications of general anaesthesia cannot be ruled out, it is a better procedure compared to open type.

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Clinicoepidemiologic profile of inguinal hernia in rural medical college in central India

Cited by 14 publications

References 2 publications

Abdominal Wall Hernias: An Epidemiological Profile and Surgical Experience from a Rural Medical College in Central India

Abdominal Wall Hernias: An Epidemiological Profile and Surgical Experience from a Rural Medical College in Central India

Association of Primary Inguinal Hernia with Body Mass Index in Patients of Bundelkhand Region of India

A comparative study between open lichtenstein mesh repair and laparoscopic totally extra peritoneal repair of inguinal hernia

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