Abstract
Venous thromboembolism (VTE) is an important postoperative complication. We investigated and analyzed the current inguinal hernia treatment methods and occurrence of early postoperative VTE in Chinese adults. This study involved data for patients with inguinal hernia hospitalized in 58 general hospitals in mainland China from January 1st, 2017 to December 31st, 2017. Data were retrospectively analyzed using a questionnaire. After data inputting and cleaning, we stratified and statistically analyzed patients' data using Caprini scores to create a high-, middle-, and low-risk group. A total of 14,322 patients with inguinal hernia were admitted to the 58 participating hospitals. After data collation and cleaning, 13,886 patients (97.0%) met our inclusion and exclusion criteria. The percentages of laparoscopic surgery and open surgery were 51.2% and 48.8%, respectively. 16 VTEs occurred during the hospitalization, accounting for 0.1% of all adverse events (95% confidence interval (CI) 0.11–0.13). The incidence of VTE was 0.2% (95% CI 0.18–0.2) in the high-risk group and 0.02% (95% CI 0.01–0.03) in the middle-risk group, based on Caprini scoring, with a significant difference (p < 0.0001). No VTE occurred in the low-risk group. Only 3,250 (23.4%) patients underwent Caprini risk assessment regarding treatment, with 13.2% receiving any prevention and only 1.2% receiving appropriate prevention. The treatment of inguinal hernia in Chinese adults has progressed somewhat; however, the evaluation and prevention of perioperative VTE was seriously neglected, in our study, and the incidence of postoperative VTE was underestimated postoperatively. Risk factors continue to be inadequately considered.
Highlights
With developments in surgical techniques and materials, satisfactory results have been achieved in the diagnosis and treatment of inguinal hernia, w orldwide[1]
It seems that pleural undergoing laparoscopic inguinal hernia repair face a higher risk of venous thrombosis than open procedure
The current medical environment and doctor-patient relationships in China are not ideal[11], and postoperative venous thromboembolism (VTE) is not associated with malignancy, it may be associated with considerable economic burden and patient danger, and surgeons’ low awareness of the risk of VTE is not helpful
Summary
With developments in surgical techniques and materials, satisfactory results have been achieved in the diagnosis and treatment of inguinal hernia, w orldwide[1]. Despite the publication of the Surgical Branch of the Chinese Medical Association’s "Guidelines for Prevention and Management of Perioperative Thrombosis in General Surgery in China" in 2016, Chinese hernia surgeons and general surgeons still pay insufficient attention to the occurrence of perioperative VTE, and it is very common for surgeons to have only a partial understanding of the perioperative management of VTE using a nticoagulants[12], especially regarding inguinal hernia. This is a very serious and common problem, and change is essential. We aimed to understand the current situation and related factors for in-hospital early postoperative VTE prevention and treatment of Chinese patients with inguinal hernia, and to provide practical basic data to support implementing the relevant guidelines
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