AIM:
To perform a retrospective clinical audit of the long-term effects of inguinal herniorrhaphy at the Victoria hospital in Prince Albert, Saskatchewan. Our hope is that this will form a template for a possible hernia registry in Saskatchewan, Canada.
PATIENTS AND METHODS:
A telephonic audit was carried out for all hernia surgeries performed in the year 2000 at the hospital. Demographics such as age and sex as well as the type of surgery and the mesh used were recorded. Chronic complications were also recorded. The surgical questionnaire was adapted from an established short quality-of-life questionnaire (Qol), the EuroQol questionnaire. We then performed a chart audit to identify basic information including the surgical approach and any intraoperative complications.
RESULTS:
Overall, 119 herniorrhaphies were performed at the Victoria hospital in 2000; 18% of patients (21/119) responded to the telephonic survey. There was a 24% complication rate. All cases of hernial recurrence arose from an original open herniorrhaphy technique. Overall, 22% of patients (27/119) had demised since the surgery; five patients remained incarcerated; and six had dementia and could not respond to the survey. The chronic inguinodynia in four patients was managed with analgesia and non-steroidal anti-inflammatories (NSAIDs). There was no need for chemical or surgical nerve ablation procedures.
CONCLUSION:
Long-term clinical audits in surgery remain sparse. There remains a paucity of data for studies that are more than a decade long. This 20-year audit of inguinal herniorrhaphy is the first of its kind in Saskatchewan, Canada. We propose its use to establish a hernia database that will record chronic complications as well as surgical outcomes. This will hopefully facilitate an improved surgical technique and a universally established method of defining and documenting complications such as chronic inguinodynia and hernia recurrence. Hernia databases help to remove patient subjectivity as well as observer bias and to provide an objective scientific overview of outcomes.
