Epidemiology and treatment of groin and ventral hernias in the Zinder region, Niger Republic

Abstract

OBJECTIVE: To describe epidemiological, therapeutic, and prognostic aspects of groin and ventral hernia in adults at Zinder National Hospital. MATERIALS AND METHODS: This was a retrospective data collected over a period of 10 years (January 2012–December 2021). All patients aged at least 18 years operated for abdominal wall hernia were included. A value of P < 0.05 was considered significant. RESULTS: A total of 921 patients were included. In these patients, groin hernia was present in 78.8% (n = 726), umbilical hernia in 13.25% (n = 122), linea alba hernia in 7.3% (n = 67), and Spiegel’s hernia in 6 cases (0.65%). The mean age was 48 ± 17.2 years. Men accounted for 80.9% (n = 745). Rural origin was 67% (n = 623) and poor 63.8% (n = 588). The stage of hernia strangulation represents 32% (n = 295). The median time to surgical consultation was 8 years. This delay was associated with rural origin (odds ratio [OR] = 1.42; P = 0.0142), poverty status (OR = 1.67; P = 0.0001), and inguinal location (OR = 1.75; 0.0371). General anesthesia was used in 58.7% (n = 541). Bowel necrosis was seen in 9.33% (n = 86). For all groin hernias (n = 783), 96.2% (n = 753) underwent herniorrhaphy and 3.8% (n = 30) underwent a Lichtenstein procedure. For all ventral hernias herniorrhaphy was performed in 95% (n = 245) and mesh repair in 5% (n = 13). Morbidity was 15.4% (n = 142) and mortality 1.74% (n = 16). This was associated with age over 60 years (OR = 3.06; P = 0.0341), ASAIII and ASAIV classes (OR = 5.21; P = 0.015), complicated clinical forms (OR = 4.87; P = 0.023), emergency surgery (OR = 4.51; P = 0.003), and the occurrence of bowel necrosis (OR = 4.11; P = 0.001). The median follow-up was 6 months (range: 3–36 months). Overall, hernia recurrence was recorded in 69 cases or 7.6%. This was associated with emergency surgery (OR = 6.26; P = 0.000) and age over 60 years (OR = 3.02; P = 0.000). CONCLUSION: In our context, the management of groin and ventral hernias is an important activity for the surgeon. Inguinal hernias predominate and hernia strangulation is an element of poor prognosis.