Study of Demographic, Risk factors and Evidence based Hernia repair and its Management in Adults in Tertiary care Hospital

Abstract

Background

 Hernia is defined as a protrusion of an organ or part (such as the intestine) through connective tissue or through wall of the cavity (as the abdomen) in which it is normally enclosed and cause pain and discomfort. Surgery is the only  method to cure this Hernia. The type of Hernia is based on the anatomical position of the body like Inguinal Hernia, Femoral Hernia, Hiatal Hernia, Incisional Hernia, Umbilical Hernia and Epi-gastric Hernia. Local anaesthetic drug is prescribed to the patient before going to surgery and then anti-biotic drugs for post-operative. The aim of the study is to evaluate demographic information including distribution of hernia patients in different hospital wards, gender and age, occupation, type of hernia, prescription drugs and risk factors associated with adults hernia patients at a Tertiary Care Hospital, Andhra Pradesh Vaidya Vidhana Parishad (APVVP) Government District Hospital, Proddatur, YSR Kadapa District, Andhra Pradesh, India.

 Methods

 This is a prospective study, which was carried out in the department of surgery for a period of 6 months. The most common Laparoscopic technique  for inguinal Hernia repair is Transdermal Peritoneal (TAPP) repair and Totally Extraperitoneal (TEP) repair. All cases were operated and procedure adopted was anatomical repair or mesh repair or laparoscopic method. History and clinical examination were required to confirm the diagnosis of clinical evidence of groin Hernia. Patient demographic information including gender, age, occupation, hernia type prescription drugs and risk factors were collected.

 Results

A total number of 110 cases of Hernia were studied with follow up period varying from 6 months. Hernia patients were distributed among three surgical wards, male surgical ward occupied highest patients with 40.9% (45 out of 110) and overall male patient predominance (62 out of 110) was observed among all the surgical wards. Age group distribution analysis revealed 60-70 years patients were found high percentage 24.5 (27 out of 110). While illiterate occupation patients were affected more by hernia compared to literate occupation, Coolly and Farmers were the illiterate outpatients affected more than 50 percent (50.8% 32 out of 63). In the literate occupation group, employees are highly affected (29.8% 14 out of 47). Inguinal hernia was found as most frequent hernia with 42.7% cases (47 out of 110). Antibiotics were the most prescribed drugs to the hernia patients. Weight lifting, pregnancy, and obesity were the main risk factors of Hernia, more than 60% of patients (65% 52 out of 80), were associated with these risk factors.

 Conclusion

In this study we found that rural area illiterate occupation population was affected more when compared to urban literate group. This could be due to occupation related risk factor weight lifting.