Abstract
Background
Enumerating the complications of groin hernia repair might help to highlight the need for improvement in the quality of care. This is imperative in a country without a strong post-operative complication surveillance mechanism. Hence, this review aims to determine the complications encountered during the surgical treatment of groin hernias among Nigerian subjects.
Methods
Databases like Google Scholar, Scopus, and PubMed were searched. Out of the 140 papers found during the search, only 20 were included in this review. Bassini repair was the most common type of hernia repair used, and neither laparoscopic repair nor posterior approach was utilized in any of the patients. Emergency presentations constituted about 18.5% of the cases. Meta-analysis of the studies showed that more prevalent complications were wound/scrotal edema (derived from four studies), surgical site infections (derived from 17 studies), and hematoma (from 19 studies). The rates were 23% (CI 0–46%; I2 = 80.9%), 6% (CI 3–10%; I2 = 87.7%), and 5% (CI 2–8%; I2 = 83.7%), respectively. The rate of complication in giant hernias was higher than the non-giant hernias and was statistically significant [p < 0.05; OR 1.5 (CI 0.9–2.4)]. Although the recurrence rate is low, there was insufficient follow-up of patients.
Conclusion
This review has shown that one-fifth of the patients had emergency repair of hernias and giant groin hernias have higher odds of complications after repair compared to normal-sized ones. The most common complication noted was wound/scrotal edema. None of the hernias was repaired with laparoscopy. Perhaps, establishing a registry might improve the detection of late complications in patients who had groin hernia repair.
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References
Nordberg EM (1984) Incidence and estimated need for caesarean section, inguinal hernia repair, and operation for strangulated hernia in rural Africa. Br Med J (Clin Res Ed) 289:92–93
Akpo EE (2013) Bilateral giant inguinoscrotal Hernia: psychosocial issues and a new classification. Afr Health Sci 13:166–170
Ogbuanya A, Amah D (2018) Delay in presentation and challenges of treatment of complicated abdominal wall hernias in rural Southeast Nigeria. Niger J Surg Sci 28:26–33
Kutzin J (2013) Health financing for universal coverage and health system performance: concepts and implications for policy. Bull World Health Organ 91:602–611
Angell B, Sanuade O, Adetifa IMO et al (2022) Population health outcomes in Nigeria compared with other West African countries, 1998–2019: a systematic analysis for the Global Burden of Disease Study. Lancet 399:1117–1129
Grimes CE, Henry JA, Maraka J et al (2014) Cost-effectiveness of surgery in low- and middle-income countries: a systematic review. World J Surg 38:252–263
Laxminarayan R, Mills AJ, Breman JG et al (2006) Advancement of global health: key messages from the Disease Control Priorities Project. Lancet 367:1193–1208
Arts DGT, De Keizer NF, Scheffer G-J (2002) Defining and improving data quality in medical registries: a literature review, case study, and generic framework. J Am Med Inform Assoc 9:600–611
Kehlet H (2008) Chronic pain after groin hernia repair. Br J Surg 95:135–136
Ndong A, Tendeng JN, Diallo AC et al (2022) Adult groin hernia surgery in sub-Saharan Africa: a 20-year systematic review and meta-analysis. Hernia 27:157–172
Mbah N (2007) Morbidity and mortality associated with inguinal hernia in North-Western Nigeria. West Afr J Med 26:288–292
Awojobi OA, Ayantunde AA (2004) Inguinal hernia in Nigeria. Trop Doct 34:180–181
Palmqvist E, Larsson K, Anell A, Hjalmarsson C (2013) Prospective study of pain, quality of life and the economic impact of open inguinal hernia repair. Br J Surg 100:1483–1488
Volmink J, Siegfried N, Robertson K et al (2004) Research synthesis and dissemination as a bridge to knowledge management: the Cochrane Collaboration. Bull World Health Organ 82:778–783
Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev 10:1–11
Ouzzani M, Hammady H, Fedorowicz Z et al (2016) Rayyan-a web and mobile app for systematic reviews. Syst Rev 5:210
Sterne JA, Hernán MA, Reeves BC et al (2016) ROBINS-I: a tool for assessing the risk of bias in non-randomised studies of interventions. BMJ 355:i4919
McGuinness LA, Higgins JPT (2020) Risk-of-bias VISualization (robvis): an R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods 12:55–61. https://doi.org/10.1002/jrsm.1411
Ogbuanya A-O, Dilibe U (2020) Bilateral inguinal hernia: epidemiology and outcomes of surgical treatment in Southeast Nigeria. Niger J Med 29:401
Oribabor FO, Amao OA, Akanni SO et al (2015) The use of nontreated mosquito-net mesh cloth for a tension-free inguinal hernia repair: our experience. Niger J Surg Off Publ Niger Surg Res Soc 21:48–51
Ayandipo OO, Afuwape OO, Irabor DO et al (2015) Adult abdominal wall hernia in Ibadan. Ann Ibadan Postgrad Med 13:94–99
Ogbuanya A, Olisa F, Oguonu A et al (2020) Feasibility and safety of prosthetic implants for inguinal hernia repair in a Nigerian tertiary Hospital. Med J Zambia 47:188–196
Etonyeaku A, Olasehinde O, Talabi A et al (2015) Groin hernias at the Wesley Guild Hospital Ilesa, Nigeria: characteristics and emerging patterns of repair. Niger J Surg Sci 25:9–12
Olasehinde OO, Adisa AO, Agbakwuru EA et al (2015) A 5-year review of darning technique of inguinal hernia repair. Niger J Surg Off Publ Niger Surg Res Soc 21:52–55
Akhator A, Oside C (2011) Giant inguinoscrotal hernias in Warri, Nigeria. AJTMBR 2:91–95
Usoro N, Agbor C, Emelike K et al (2008) Early outcome of inguinal hernia repair using Ultrapro® mesh in the University Of Calabar Teaching Hospital, Nigeria. Internet J Third World Med 6(2). http://www.researchgate.net/article
Abur P, Daniyan M, Nwabuoku S et al (2020) Changing pattern of adult external abdominal hernias in Zaria. Port Harcourt Med J 14:19–22
Ogbuanya AU-O, Olisa FU, Ewah RL et al (2020) Femoral Hernia: Epidemiology and challenges of management in a sub-Saharan African Country. Asian J Med Sci 11:77–83
Olaogun JG, Afolayan JM, Areo PO et al (2018) Repair of groin hernia under local anaesthesia in a secondary health facility. ANZ J Surg 88:E294–E297
Enyinnah M, Dienye PO, Njoku P (2013) Inguinal mesh hernioplasties: a rural private clinic experience in South Eastern Nigeria. Glob J Health Sci 5:176–181
Arowolo OA, Agbakwuru EA, Adisa AO et al (2011) Evaluation of tension-free mesh inguinal hernia repair in Nigeria: a preliminary report. West Afr J Med 30:110–113
Osifo O, Amusan TI (2010) Outcomes of giant inguinoscrotal hernia repair with local lidocaine anesthesia. Saudi Med J 31:53–58
Adesunkanmi A, Badmus T, Ogundoyin O (2004) Determinants of the outcome of inguinal herniorrhaphy in Nigerian patients. Ann Coll Surg Hong Kong 8:14–21
Adesunkanmi AR, Agbakwuru EA, Badmus TA (2000) Obstructed abdominal hernia at the Wesley Guild Hospital, Nigeria. East Afr Med J 77:31–33
Ibrahim AG, Aliyu S, Mohammed BS (2014) Giant inguinal hernia: our experience in Maiduguri, North Eastern Nigeria. Int J Sci Res 3:2723–6
Agbakwuru EA, Olasehinde O, Onyeze CI et al (2020) Use of commercial mesh for hernia repair in a low resource setting: experience after 500 cases. Hernia 24:613–616
Olasehinde O, Lawal OO, Agbakwuru EA et al (2016) Comparing Lichtenstein with Darning for inguinal hernia repair in an African population. Hernia 20:667–674. https://doi.org/10.1007/s10029-016-1498-2
Awe J, Ugwi V, Omon H (2014) Inguinal hernias: analysis of incidence, diagnosis and management of 172 consecutive adult cases at Igbinedion University Teaching Hospital Okada. Glob Adv Res J Med Med Sci 3:168–172
Ndong A, Tendeng JN, Diallo AC et al (2023) Adult groin hernia surgery in sub-Saharan Africa: a 20-year systematic review and meta-analysis. Hernia 27:157–172
Odula P, Kakande I (2004) Groin hernia in Mulago Hospital, Kampala. East Cent Afr J Surg 9(1)
Zeb MH, Pandian TK, El Khatib MM et al (2016) Risk factors for postoperative hematoma after inguinal hernia repair: an update. J Surg Res 205:33–37
Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403
Bittner R, Sauerland S, Schmedt C-G (2005) Comparison of endoscopic techniques vs Shouldice and other open non-mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc Other Interv Tech 19:605–615. https://doi.org/10.1007/s00464-004-9049-9
Berthier N, Olivier D, Willy A (2017) Inguinal hernia surgery in developing countries: should laparoscopic repairs be performed? Pan Afr Med J 27:5
Dalwani AG, Shaikh AR, Memon S (2009) Management of giant inguinal hernia. J Liaquat Univ Med Heal Sci 8:29–33
Oyewale S, Ariwoola A. (2023) Outcomes in the surgical management of giant inguinal hernias: a systematic review. Int J Abdom Wall Hernia Surg. 6:6–13
Simons MP, Smietanski M, Bonjer HJ et al (2023) International guidelines for groin hernia management. Hernia 22:1–165. https://doi.org/10.1007/s10029-017-1668-x
Staarink M, van Veen RN, Hop WC et al (2008) A 10-year follow-up study on endoscopic total extraperitoneal repair of primary and recurrent inguinal hernia. Surg Endosc 22:1803–1806
Neumayer L, Giobbie-Hurder A, Jonasson O et al (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827
Scheuerlein H, Schiller A, Schneider C et al (2003) (2003) Totally extraperitoneal repair of recurrent inguinal hernia. Surg Endosc 17(7):1072–1076
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Oyewale, S., Ariwoola, A. Evaluating the complications of adult groin hernia where there is no hernia registry: a systematic review of Nigerian literature. Hernia 28, 367–375 (2024). https://doi.org/10.1007/s10029-023-02938-1
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DOI: https://doi.org/10.1007/s10029-023-02938-1