Journal Article

Surgical Challenges During the COVID-19 Crisis: A Comparative Study of Inguinal Hernia Treatment in Romania

Feier, Catalin Vladut Ionut, Vonica, Razvan Constantin, Murariu, Marius-Sorin, Olariu, Sorin, Faur, Alaviana Monique, Muntean, Calin, Gaborean, Vasile

2024

Overview

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.

• Publisher: MDPI AG,MDPI
• Subject: Adult / Aged / Comorbidity / Comparative analysis / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / COVID-19 - transmission / COVID-19 pandemic / Disease transmission / Elective surgery / Elective Surgical Procedures - adverse effects / Elective Surgical Procedures - instrumentation / Elective Surgical Procedures - methods / Elective Surgical Procedures - statistics & numerical data / Emergency Treatment - adverse effects / Emergency Treatment - instrumentation / Emergency Treatment - methods / Emergency Treatment - statistics & numerical data / Female / Health aspects / Hernia, Inguinal - complications / Hernia, Inguinal - surgery / Hernias / Herniorrhaphy - adverse effects / Herniorrhaphy - instrumentation / Herniorrhaphy - methods / Herniorrhaphy - statistics & numerical data / hospitalization / Humans / Inguinal hernia / inguinal hernia repair / Intervention / Length of Stay - statistics & numerical data / Male / Middle Aged / Normal distribution / Operative Time / Pandemics / Pandemics - prevention & control / Pandemics - statistics & numerical data / Patient Isolation / Patients / Postoperative Complications - epidemiology / Postoperative Complications - etiology / Retrospective Studies / Romania - epidemiology / Severe acute respiratory syndrome coronavirus 2 / Statistical analysis / Surgery / Surgical mesh / Variance analysis