Impact of the COVID-19 pandemic on hernia surgery in a Swedish healthcare region: a population-based cohort study

Abstract

Background Swedish healthcare has been reorganised during the COVID-19 pandemic, affecting the availability of surgery for benign conditions. The aim of this study was to determine the effects of COVID-19 on emergency and elective hernia surgery in a Swedish healthcare region. Methods Using procedure codes, data from inguinal and ventral hernia procedures performed at the three hospitals in Jönköping Region, Sweden, from March 1st 2019 to January 31st 2021, were retrieved from a medical database. The cohort was divided into two groups: the COVID-19 group (March 1st 2020–January 31st 2021) and the control group (March 1st 2019–January 31st 2020). Demographic and preoperative data, hernia type, perioperative findings, and type of surgery were analysed. Results A total 1329 patients underwent hernia surgery during the study period; 579 were operated during the COVID-19 period and 750 during the control period. The number of emergency ventral hernia repairs increased during the COVID-19 period, but no difference in inguinal hernia repair rate was seen. The characteristics of patients that underwent hernia repair were similar in the two groups. Moreover, the decrease in elective ventral hernia repair rate during the COVID-19 period did not result in a higher risk for strangulation. Conclusion There is no evidence to suggest that the decrease in the number of elective ventral hernia repairs during the COVID-19 period had any impact on the risk for strangulation. Indications for surgery in patients with a symptomatic ventral or inguinal hernia should be carefully evaluated. Studies with greater power and longer follow-up are needed to gain a full understanding of the effects of the COVID-19 pandemic on hernia surgery.

Effect of the SARS-CoV-2 pandemic on planned and emergency hernia repair in Sweden: a register-based study

“…The authors concluded that there was a 24% increase in emergency inguinal hernia repairs during the COVID-19 pandemic lockdown despite the overall reduction in emergency hernia repairs [ 17 ]. Other studies based in Sweden [ 9 ] and Turkey [ 17 ] either showed no changes in the number of emergency inguinal repairs or found a decrease of emergency inguinal repairs during the COVID-19 period respectively. However, both aforementioned studies found that the number of emergency ventral hernia repairs increased during the COVID-19 pandemic period.…”

“…COVID-19 had a far-reaching impact on the health care system, forcing a widespread reallocation of resources and medical personnel [ 6 – 8 ]. This resulted in the postponement of many operations for benign conditions [ 9 – 11 ]. It is estimated that worldwide, more than 2 million operations were delayed per week during the first wave of the pandemic, the majority of which were planned [ 8 , 12 ].…”

The unexpected social cost of inguinal hernioplasty procedures derived from the COVID‐19 pandemic: Surgical trend analysis based on an Italian hospital series

“…Moreover, a baseline decrease was reported in the elective scheduled surgeries in early 2020 as the result of governmental counteracts, 7 also with a consequent modification of the selection criteria of patients on the waiting list 8 . On the other hand, a steady curve before and during the pandemic regarding the number of urgent hernioplasty has been also reported 9 . Lastly, some authors suggested that in mildly symptomatic patients a safe management of the waiting list was obtained through the assessment of analgesic consumption and anamnestic frailty 10 …”

“…8 On the other hand, a steady curve before and during the pandemic regarding the number of urgent hernioplasty has been also reported. 9 Lastly, some authors suggested that in mildly symptomatic patients a safe management of the waiting list was obtained through the assessment of analgesic consumption and anamnestic frailty. 10 During the pandemic time, it was debated the feasibility of the Taxis maneuver in order to procrastinate as much as possible on the hernia correction presented in an emergency setting, in most cases at the expense of a worsened quality of life perception and patient safety.…”

Before and after COVID‐19 pandemic: impact on hepatobiliary and pancreatic surgical services in a Singapore Tertiary Hospital

“…Other authors have also observed a decrease in elective hernia load without a corresponding increase in emergency hernia load. Kollatos et al 16 described how the overall number of emergency hernia repairs did not increase during the COVID-19 period in their healthcare region despite a decrease in elective procedures. Other studies [17][18][19] have also described decreased emergency hernia surgery rates during the pandemic.…”