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

Adamou, Harissou; Amadou, Ibrahim Magagi; Adakal, Ousseini; Hamidou, Abdel Nasser M.; Hassane, Maman Laoul; Didier, Lassey James; Sani, Rachid

doi:10.4103/ejs.ejs_253_23

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

Authors

Abstract

Background
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.
Patients and Methods
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.
Results
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% (=196). The median operative time was 7 h. The Bassini procedure was the most common with 83.5% (=192). Small bowel was the content of the hernia sac in 80% (=184). Intestinal necrosis occurred in 10.9% (=25). This was associated with femoral location (OR=5.39, =0.00003). Intestinal resection was performed in 13.9% (=32) and stoma in 1.7% (=4). Postoperative complications occurred in 25.2% (=58). The overall mortality (grade V) was 6.5% (=15). Mortality was statistically associated with age > 60 years (OR=5.16; =0.0016), admission time (OR=3.20; =0.028), time to surgery > 8 h (OR=4.20; =0.005) and occurrence of necrosis (OR=9.39; =0.000).
Conclusion
Strangulated groin hernia is a common surgical emergency. Its prognosis is associated with advanced age, femoral location, and diagnostic and therapeutic delay.

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