Emergency vs. elective inguinal hernia repairs: early differences with similar long-term outcomes

Emergency inguinal hernia repair is associated with increased perioperative risk, but its effect on longer-term outcomes remains unclear. Adult patients undergoing inguinal hernia repair between 2022 and 2024 were analyzed, comparing emergency and elective procedures. Demographic and perioperative data were obtained from medical records. Recurrence and chronic pain (≥ 6 months) were assessed prospectively using structured telephone follow-up at 12-18 months. Among 400 patients, 26 (6.5%) underwent emergency repair and 374 (93.5%) elective repair; follow-up was available for 292 patients (73%). Emergency patients were older (median 73.0 vs. 64.0 years; p = 0.011), had longer operative time (80.0 vs. 65.0 min; p < 0.001), and longer hospital stay (2.0 vs. 1.0 days; p < 0.001). Surgical site infection within 90 days occurred more frequently after emergency repair (7.7% vs. 1.3%; OR 5.93, 95% CI 1.08-32.74; p = 0.041), with similar results in open repairs only. Recurrence (3.8% vs. 3.5%) and chronic pain (11.5% vs. 13.4%) did not differ between emergency and elective repairs (both p > 0.05). Emergency inguinal hernia repair is associated with higher early postoperative morbidity, while recurrence and chronic pain rates during mid-term follow-up are comparable to elective surgery.