The effects of COVID-19 pandemic on emergency anterior abdominal wall hernia surgery: is it safe to postpone elective hernia surgery in the pandemic?

Abstract

Background The aim of this study was to investigate the effects of the COVID-19 pandemic on emergency anterior abdominal wall hernia surgeries (EAAWHS) by comparing the pandemic period with the control period a year ago and to share our experiences in the pandemic period. Methods This single-center retrospective cohort study included all patients who underwent EAAWHS during the pandemic (from 11 March 2020 to 25 January 2021) and control period (1 year before the same period, from 11 March 2019 to 25 January 2020). Demographic data, preoperative clinical and pathological parameters, intraoperative findings and postoperative complications secondary to operation and COVID-19 infection, length of intensive care and hospital stay of patients were recorded, and the pandemic and control groups were compared. Results Of the 87 patients who underwent anterior abdominal wall hernia surgery during the COVID-19 pandemic, 41 (47.1%) were operated emergently and 46 (52.9%) were operated electively. Of the 485 patients who underwent anterior abdominal wall hernia surgery during the control period, 24 (4.95%) were operated emergently and 461 (95.05%) were operated electively. The decrease in the number of elective operations and the increase in the number of emergency operations were significant during the pandemic ( p < 0.001).There was a decrease in the number of emergency inguinal hernia operations and an increase in the number of emergency ventral (incisional, umbilical) hernia operations during the pandemic period compared to the control period ( p < 0.05).The mortality rates were similar (8.3 vs. 9.8%, p > 0.05) in both periods. Conclusion Despite the increase in the number of EAAWHS during the COVID-19 pandemic, there was no significant difference in mortality and morbidity rates. EAAWHS can be performed safely during the pandemic by taken necessary and adequate precautions.

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

“…Similar to our research, some published studies found a significant decrease in elective surgical treatment for anterior wall abdominal hernias during the Covid‐19 period, 4 also referring to those complicated or not complicated as a paradoxical effect of the pandemic, 5 or perhaps due to the stay‐at‐home government indications 6 . 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 .…”

Asymptomatic inguinal hernia: does it need surgical repair? A systematic review and meta‐analysis

“…Almost all studies showed that WW delays, but does not remove the need for surgical treatment of inguinal hernia, while the risk of complications in case of watchful waiting WW is low and the risk of chronic pain after hernia surgery remains high. A current consideration is that the COVID-19 pandemic 43 may have increased surgeons' [44][45][46] and patients' 47 interest for WW, as well as the reduced opportunity for elective inguinal hernia repairs performed, 48 providing more future data, but no definitive conclusion can be drawn up to now. authors contributed to the study conception and design.…”

Another Brick in the Wall

“…1 This is especially true since the COVID-19 pandemic, during which benign pathologies fell by the wayside. 4,5 Too many acronyms still exist, with few clear definitions for complications, different methods of management (1-day surgery, outpatient surgery, elective and emergency surgery), too many differences in codifying both the disease and treatment (open, robotic, laparoscopy), too much heterogeneity in national healthcare systems when approaching abdominal wall pathology (insurance healthcare or welfare healthcare) and too many differences between low and high-volume centers or hub and spoke centers. Moreover, considering the increasing marketing of different products, such as meshes, laparoscopic and robotic instruments, it is hard to understand how to navigate this world without defined routes while avoiding confusion and complicating the lives of young colleagues who encounter the disease.…”

“…Despite the efforts of various scientific societies dedicated to abdominal wall surgery, too much confusion has remained, and abdominal wall hernia is still sometimes neglected if we compare it with oncological diseases 1. This is especially true since the COVID-19 pandemic, during which benign pathologies fell by the wayside 4,5…”