Emergent groin hernia repair in a tertiary government hospital in the Philippines: a 7-year review of case profiles, management practices, and post-operative outcomes

Groin hernias are among the most common causes for surgical consult globally. This study analyzed the case profiles, management practices, and post-operative outcomes of emergency groin hernia repairs over a 7-year period in a tertiary government hospital in the Philippines.

A retrospective, descriptive, cross-sectional study was conducted of adult patients who underwent emergency groin hernia repair at the Philippine General Hospital between January 1, 2017 and December 31, 2023. Case characteristics, surgical approaches, and outcomes were examined. Inferential statistics were used to analyze the associations between risk factors and key outcomes (complications, mortality, and recurrence).

Among 2,341 adult hernia admissions, 711 (30%) were emergencies; 551 of these underwent surgery. The emergency-to-total repair ratio (ET/H) was 26.3. Most patients were male (98%), with a mean age of 50.7. Most hernias were right-sided (61%), indirect (96%), and presented as acutely irreducible (68%). Strangulation was seen in 11%, and 6% were recurrent cases. The COVID-19 years showed reduced admissions and longer hospital stays. Lichtenstein repair was the most used technique overall (80%), while tissue repairs were preferred in 52% of strangulated cases. In the early post operative period, complication rate was 8% while mortality was 3%. Strangulation strongly predicted wound complications (OR 5.0, 95% CI 1.9–13.3, p = 0.003) and mortality (OR 16.3, 95% CI 5.3–50.4, p < 0.00001). Recurrence occurred in 2.6% of followed-up cases, and was significantly more likely in patients with comorbidities (OR 2.72, 95% CI 1.32–5.61, p = 0.0066).

Emergency hernia repair remains a significant surgical burden in the Philippines, reflecting gaps in surgical access, capacity, and early intervention. At PGH, most patients are young and present severely, with repairs performed predominantly by trainees using open techniques. Despite these constraints, outcomes remain within global standards, underscoring the need to standardize care and strengthen training and research.