COMPARATIVE OUTCOMES OF EMERGENCY AND ELECTIVE ABDOMINAL WALL HERNIA REPAIR IN ADULTS
DOI:
https://doi.org/10.48047/yjwegv06Keywords:
Hernia repair, Emergency surgery, Elective surgery, Strangulation, Bowel resectionAbstract
This comparative cohort study demonstrated that patients undergoing emergency abdominal wall hernia repair experienced substantially poorer postoperative outcomes than those treated electively. Emergency surgery was associated with significantly higher rates of 30-day mortality, major postoperative complications, surgical-site infections, bowel resection, and prolonged hospitalization. These findings are clinically important because they highlight the consequences of delayed presentation and the progression of hernias to incarceration, obstruction, or strangulation, conditions that often necessitate urgent intervention and increase operative complexity. The markedly higher requirement for bowel resection among emergency cases suggests a greater burden of ischemic or non-viable bowel, which contributes to increased morbidity and mortality. Furthermore, the elevated incidence of surgical-site infection and other major complications may reflect contamination associated with bowel compromise, longer operative times, and the reduced physiological reserve of acutely ill patients. Multivariable analysis confirmed that emergency presentation remained an independent predictor of adverse outcomes even after adjustment for potential confounders, emphasizing that the timing and circumstances of surgery are critical determinants of prognosis. These results are consistent with previous reports showing superior outcomes following planned elective hernia repair compared with emergency procedures. From a healthcare perspective, timely identification and elective repair of symptomatic hernias may prevent progression to emergency conditions, reduce postoperative complications, shorten hospital stay, and decrease healthcare costs. Particular attention should be directed toward elderly individuals and patients with comorbidities who may be at increased risk of emergency presentation. Overall, the study provides strong evidence supporting proactive elective management of abdominal wall hernias whenever clinically appropriate. Future multicentre prospective studies are warranted to validate these findings and identify strategies that further reduce emergency hernia presentations and their associated complications
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