Comparative Assessment of Intraoperative Complications in Inguinal Hernia Repair Surgery in Healthy Patients Versus Comorbid Patients

Abstract

Background: Inguinal hernia repair is a common surgical procedure, yet the impact of patient comorbidities on intraoperative complications remains insufficiently explored, posing challenges for risk stratification and perioperative management. Objective: This study aimed to compare the incidence and spectrum of intraoperative complications between healthy patients and those with comorbidities undergoing inguinal hernia repair, with a focus on identifying high-risk subgroups and informing evidence-based perioperative strategies. Methods: An analytical cross-sectional study was conducted at Lahore General Hospital over six months, enrolling 150 adult patients scheduled for elective inguinal hernia repair. Eligible patients included those with or without comorbidities such as diabetes, hypertension, ischemic heart disease, chronic kidney disease, or chronic obstructive pulmonary disease; patients with other hernia types or emergent cases were excluded. Data was collected using structured questionnaires and operative records, capturing demographic, clinical, and intraoperative variables. Complications were graded using the Clavien-Dindo system. Comparative analyses were performed using chi-square tests and logistic regression, with results expressed as odds ratios and 95% confidence intervals. Data analysis was conducted using SPSS v26. The study protocol received IRB approval and adhered to the Helsinki Declaration. Results: Intraoperative bleeding occurred in 26.5% of comorbid patients versus 12.5% of healthy patients (p=0.030, OR 2.53, 95% CI: 1.08–5.95). Anesthesia-related complications were more frequent among comorbid patients (36.3% vs 20.8%, p=0.045, OR 2.14, 95% CI: 1.02–4.51), as were postoperative pain (30.4% vs 12.5%, p=0.011) and cardiopulmonary events (36.3% vs 18.8%, p=0.018). COPD conferred the highest risk across all complication categories. Conclusion: Comorbid conditions, especially COPD, significantly increase the risk of intraoperative complications in inguinal hernia repair, underscoring the necessity of personalized perioperative care and vigilant monitoring for high-risk patients to improve surgical outcomes.