Impacto de la pandemia en el manejo de la hernia inguinal en lactantes / Pandemic’s impact on inguinal hernia management in infants

RESUMEN

Introducción: La pandemia del SARS-CoV-2 supuso una reducciónde las jornadas quirúrgicas. Analizamos el efecto en la morbilidad dela hernia inguinal.Material y método: Estudio retrospectivo de casos y controles.Incluimos menores de 18 meses intervenidos de hernia inguinal desde01/01/2019 hasta 31/08/2020, divididos en dos grupos: intervenidos an-tes (grupo A) o después (grupo D) de la declaración del estado de alarma.Variables principales: episodios de incarceraciones y complicacionespostoperatorias. Variable secundaria: intervención urgente o programada.Variables poblacionales: sexo, edad gestacional (EG), patología previa,edad al diagnóstico (ED) y a la intervención (EI) (meses).Resultados: Incluimos 64 pacientes, 43 grupo A y 21 grupo D. En el grupo A la mediana de EG fue 37+3, el 90,5% fueron varones, la mediana ED fue 2,33 y EI 3,27. En el grupo B la mediana de EG fue 31+2, el 72,1% fueron varones, la mediana ED fue 3 y EI 3,63. No hubo diferencias estadísticamente significativas. Sí fueron significativas las diferencias en patología previa: 16,3% A y 38,1% D (p = 0,05). Sobre la variable principal, 25,6%, del A sufrieron incarceraciones frente a 33,3% del D (p = 0,51) y un 9,3% tuvieron morbilidad postoperatoriaen A frente al 14,3% en D (p = 0,41). Respecto a la variable secundaria, un 88,4% se realizaron de forma programada en el grupo A y un 90,5% en el grupo D (p = 0,583). Conclusión: Pese a la reducción de jornadas quirúrgicas, no ha aumentado la morbilidad de la hernia inguinal en nuestro medio. Hemos observado un aumento de pacientes con patología previa, implicando la priorización de los pacientes más graves.

ABSTRACT

Introduction: The SARS-CoV-2 pandemic brought about a reduction in surgical activity. The objective of this work was to analyze its impact on inguinal hernia morbidity.Materials and methods: A retrospective study of cases and controls was carried out. Patients under 18 months of age undergoing inguinal hernia surgery from January 1, 2019 to August 31, 2020 were included. They were divided into two groups: patients undergoing surgery before (group A) or after (group D) the state of alarm was declared in Spain.Primary variables: episodes of incarceration and postoperative complications. Secondary variable: urgent or scheduled surgery. Demographic variables: sex, gestational age (GA), previous pathologies, age at diagnosis (AD), and age at surgery (AS) (months).Results: 64 patients were included – 43 in group A and 21 in group D. In group A, median GA was 37+3, 90.5% of patients were male, median AD was 2.33, and median AS was 3.27. In group D, median GA was 31+2, 72.1% of patients were male, median AD was 3, and medianAS was 3.63. There were no statistically significant differences. However, differences in terms of previous pathologies were significant (16.3% for Group A vs. 38.1% for group D) (p = 0.05). Regarding the primary variable, 25.6% of patients in group A had incarcerations vs. 33.3% ofpatients in group D (p = 0.51), whereas 9.3% of patients in group A had postoperative morbidity vs. 14.3% of patients in group D (p = 0.41). Regarding the secondary variable, 88.4% of surgeries in group A were scheduled vs. 90.5% of surgeries in group D (p = 0.583).Conclusion. In spite of reduced surgical activity, inguinal hernia morbidity did not surge in our environment. An increase in patients with previous pathologies was noted, which means severe patients should be prioritized.