Strangulated groin hernia prognosis in adults in sub-Saharan African context: Retrospective study at Zinder, Niger

Abstract

In our context, hernial strangulation has a high incidence. The aim of this work was to investigate prognostic factors in adults diagnosed with strangulated groin hernia. This was a retrospective cross-sectional study conducted at Zinder National Hospital between 1 January 2016 and 31 December 2022 (7 years). Clinical and prognostic data were collected. Out of 568 patients who underwent surgery for groin hernia, 230 cases were strangulated (40.49%). Mean age was 47.8±16.6 years. The proportion of males was 86.65%, i.e. the sex ratio was 5.96. Inguinal hernia accounted for 85.2% (n=196). The median operative time was 7 h. The Bassini procedure was the most common with 83.5% (n=192). Small bowel was the content of the hernia sac in 80% (n=184). Intestinal necrosis occurred in 10.9% (n=25). This was associated with femoral location (OR=5.39, P=0.00003). Intestinal resection was performed in 13.9% (n=32) and stoma in 1.7% (n=4). Postoperative complications occurred in 25.2% (n=58). The overall mortality (grade V) was 6.5% (n=15). Mortality was statistically associated with age > 60 years (OR=5.16; P=0.0016), admission time (OR=3.20; P=0.028), time to surgery > 8 h (OR=4.20; P=0.005) and occurrence of necrosis (OR=9.39; P=0.000). Strangulated groin hernia is a common surgical emergency. Its prognosis is associated with advanced age, femoral location, and diagnostic and therapeutic delay.