CLINICAL OUTCOMES AND COMPLICATIONS FOLLOWING CONVENTIONAL HERNIOLPASTY FOR INGUINAL HERNIAS
CLINICAL OUTCOMES AND COMPLICATIONS FOLLOWING CONVENTIONAL HERNIOLPASTY FOR INGUINAL HERNIAS

Summary/Abstract: The surgical treatment of inguinal hernias remains one of the most frequently performed procedures in general surgery. The selection of an appropriate surgical method should be based on an individualized, evidence based approach that considers the patient's condition, anatomical factors, and surgeon experience. Among the variety of techniques available, conventional tension free hernioplasty particularly the Lichtenstein procedure has emerged as the most widely accepted method. This approach involves the reconstruction of the posterior inguinal wall using a polypropylene mesh via an anterior, transinguinal route. Its low recurrence rates and complications have positioned it as the "gold standard" in inguinal hernia repair worldwide. This study presents a combined retrospective and prospective analysis of patients undergoing open conventional hernioplasty, with a specific focus on intraoperative and early postoperative complications, recurrence, patient recovery, postoperative pain, and quality of life. A total of 182 patients were initially considered, with 180 included in the final analysis. All surgeries were performed at the Department of General Surgery, Clinical Hospital – Stip (North Macedonia), and the Clinic for Abdominal Surgery, Medical University – Plovdiv (Bulgaria). From 180 patients, 165 were male and 17 were female, ranging in age from early adulthood to elderly. Preoperatively, 13.3% of patients reported groin pain requiring analgesic therapy. Postoperative monitoring revealed minor complications in a small proportion of patients, including surgical wound seroma (2.5%), hematoma (1.67%), hydrocele formation (1.67%), urinary retention (0.83%), and transient neurological symptoms such as numbness or paresthesia (2.5%). No major intraoperative complications, mesh infections, or mortalities were recorded. The average hospital stay was 3.8 ± 1.4 days, with a range of 2 to 7 days. Most patients resumed daily activities within two weeks of discharge, with only a few requiring extended convalescence. The study findings confirm the reliability, safety, and efficiency of conventional hernioplasty for the treatment of inguinal hernias. The Lichtenstein technique, in particular, demonstrates consistently favorable outcomes, with recurrence rates reported in the literature ranging from 0.2% to 0.7% for primary hernias and up to 2% for recurrent cases. These results support the ongoing use of this technique in clinical practice. Nevertheless, proper patient selection, meticulous surgical technique, and postoperative follow-up are essential to minimize complications and improve long-term outcomes. The data also underscore the importance of continuous surgical training and quality control in maintaining high standards in hernia surgery

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