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Surgical Challenges During the COVID-19 Crisis: A Comparative Study of Inguinal Hernia Treatment in Romania
Catalin Vladut Ionut Feier1,2, Calin Muntean3, Vasile Gaborean4,5
1Abdominal Surgery and Phlebology Research Center, "Victor Babeş" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Insights
The COVID-19 pandemic reduced elective inguinal hernia repair (IHR) surgeries, increasing emergency cases. Strategies are needed to maintain essential surgical care during crises to prevent complications.
Area of Science:
- General Surgery
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted global healthcare, leading to postponements of elective surgeries like inguinal hernia repair (IHR).
- Healthcare systems reallocated resources to manage critical care needs during the pandemic.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on the incidence and outcomes of inguinal hernia repair (IHR) procedures.
- To analyze changes in surgical approach, patient demographics, and postoperative results during pre-pandemic, pandemic, and post-pandemic periods.
Main Methods:
- A retrospective review of 604 patients who underwent IHR over six years (pre-pandemic, pandemic, post-pandemic).
- Analysis of patient demographics, surgical procedure type (elective vs. emergency), mesh use, surgical duration, hospitalization, and postoperative outcomes.
Main Results:
- A significant increase in female patients undergoing IHR was observed during and after the pandemic.
- Elective IHR surgeries decreased significantly during the pandemic, with a corresponding rise in emergency cases.
- Mesh repair usage increased post-pandemic, while surgical duration increased during the pandemic. Hospital stays were reduced during and after the pandemic.
Conclusions:
- The pandemic necessitated a shift towards emergency inguinal hernia repairs, highlighting potential risks associated with delayed elective procedures.
- Robust healthcare strategies are crucial for maintaining elective surgical services during global health crises to prevent complications such as hernia incarceration and strangulation.
Abstract:
Background and Objectives: The COVID-19 pandemic disrupted healthcare systems worldwide, leading to the postponement of elective surgeries, including inguinal hernia repair (IHR), as healthcare resources prioritized critical care. This study aims to evaluate the impact of the pandemic on the incidence and outcomes of IHR procedures. Materials and Methods: A retrospective review was conducted on 604 patients who underwent IHR over six years, spanning pre-pandemic, pandemic, and post-pandemic periods. Data on patient demographics, type of surgical procedure (elective or emergency), use of mesh, surgical duration, hospitalization period, and postoperative outcomes were analyzed across the three time frames. Results: Patient age remained consistent across the three periods, but a significant increase in female patients was observed during and after the pandemic (p < 0.001). Elective IHR surgeries significantly decreased during the pandemic (p < 0.001), paralleled by an increase in emergency cases (p = 0.004). In the post-pandemic period, elective surgeries rebounded, while emergency interventions declined (21.9% vs. 10.3%). Mesh repair usage increased notably in the post-pandemic phase (p < 0.001). Although surgeries took longer during the pandemic (p < 0.001), both total and postoperative hospital stays were reduced during and after the pandemic (p < 0.001). Minimal postoperative complications were reported throughout, with only one mortality during the pandemic. Conclusions: This study highlights the need for robust healthcare strategies to maintain elective surgical care during global crises, as delays in IHR may elevate risks for complications like hernia incarceration and strangulation.
