Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Dec;77(8):2591-2600.
doi: 10.1007/s13304-025-02084-6. Epub 2025 Mar 25.

Ambulatory inguinal hernia repair in Portugal - a multicenter prospective cohort study

PTSurg (Portuguese Surgical Research Collaborative)
Collaborators
Observational Study

Ambulatory inguinal hernia repair in Portugal - a multicenter prospective cohort study

PTSurg (Portuguese Surgical Research Collaborative). Updates Surg. 2025 Dec.

Abstract

Ambulatory surgery is the recommended approach for elective inguinal hernia repair for most people. However, the relative use of this procedure in Portugal and its related outcomes are unknown. We aimed to assess complication rates in patients undergoing ambulatory and inpatient surgery. Prospective multicentric cohort study included consecutive patients undergoing elective inguinal hernia repair in mainland Portugal (October-December 2019). The primary outcome was the post-operative complication rate (any Clavien-Dindo grade) among patients undergoing ambulatory and inpatient surgery. A logistic regression analysis was performed to adjust for patient and disease-related co-variables. Eight hundred twenty-eight patients (89.1% of males) were included from thirty-three hospitals, of which seven hundred sixteen (86.4%) had unilateral hernias. Four hundred thirty-three (52.2%) were operated on as day cases and three hundred ninety-five (47.7%) with overnight stays. There were no significant differences in post-operative complication rate between patients undergoing ambulatory and overnight stay surgery, both in unadjusted (9.9% vs. 11.1%; p = 0.650) and adjusted (odds ratio: 1.08 [95% CI 0.66-1.76]) analyses. Ambulatory surgery was only performed in half of the patients, although this procedure is not associated with an increased risk of complications. These results should promote the expanded use of ambulatory surgery in patients eligible for elective inguinal hernia repair.

Keywords: Ambulatory surgical procedures; Hernia; Inguinal; Perioperative care; Postoperative complications.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: The authors have no relevant financial or non-financial interests to disclose. Informed consent: Informed consent was obtained from all individual participants included in the study. Human rights: The authors declare that the procedures were followed according to the regulations established by the Clinical Research and Ethics Committee and to the Helsinki Declaration of the World Medical Association updated in 2013. Clinical trial number: NCT04328597.

Figures

Fig. 1
Fig. 1
Data collection timeline. With permission from PTSurg, 2020 [14]
Fig. 2
Fig. 2
Flow diagram
Fig. 3
Fig. 3
Baseline characteristics of excluded patients
Fig. 4
Fig. 4
Baseline patient characteristics and rate of post-operative complications by mode of care
Fig. 5
Fig. 5
Baseline patient characteristics and rate of post-operative complications by mode of care in selected low-risk patients
See this image and copyright information in PMC

References

    1. Kingsnorth A, LeBlanc K (2003) Hernias: inguinal and incisional. The Lancet 362:1561–1571. 10.1016/S0140-6736(03)14746-0 - DOI - PubMed
    1. Young DG, Carachi R (2006) James H Nicoll, MB, CM Glasg, FRFPS Glasg. Legion of Honour France, father of day surgery. Scott Med J 51:48–50. 10.1258/rsmsmj.51.1.48 - DOI - PubMed
    1. Farquharson EL (1955) Early ambulation with special reference to herniorrhaphy as an outpatient procedure. The Lancet 266:517–519. 10.1016/S0140-6736(55)93272-4 - DOI - PubMed
    1. Goulbourne IA, Ruckley CV (1979) Hospital topics operations for hernia and varicose veins in a day-bed unit. BMJ. 10.1136/bmj.2.6192.712 - DOI - PMC - PubMed
    1. Prescott RJ, Cutherbertson C, Fenwick N, Garraway WM, Ruckley CV (1978) Economic aspects of day care after operations for hernia or varicose veins. J Epidemiol Community Health 32:222–225. 10.1136/jech.32.3.222 - DOI - PMC - PubMed

Publication types

LinkOut - more resources