Relationship of timing of surgical intervention on clinical outcomes in adults with inguinal hernias: a retrospective observational study in hospitals of northern West Bank

This retrospective cohort study analyzed data from 180 adult patients who underwent inguinal hernia repair at 7 hospitals in the northern West Bank over 2 years. The study investigated patient demographics, surgical characteristics, and factors associated with postoperative complications, with a particular focus on the timing of surgery.Data were collected from hospital records and confirmed through follow-up phone interviews, capturing variables such as age, body mass index (BMI), hernia size and laterality, smoking status, surgical technique, and time from diagnosis to surgery. The findings demonstrated that delayed surgical intervention was significantly associated with higher complication rates. Patients who underwent surgery within 3 months of diagnosis served as the reference group with a relative risk (RR) = 1.00, while those who had surgery between 3 and 6 months had an RR of 1.69, and those treated after more than 6 months had an RR of 2.11. These figures indicate that delaying surgery beyond 6 months more than doubled the risk of postoperative complications.In addition to surgical delay, other factors significantly associated with increased complication rates included age over 44 years, BMI ≥27 kg/m², bilateral hernias, and larger hernia size. Open mesh repair, the most commonly used technique (93.9% of cases), was linked to higher complication rates compared to laparoscopic repair. Conversely, patients who received surgery within 1-3 months reported better postoperative health outcomes and the highest levels of satisfaction.This study highlights the critical importance of timely surgical intervention in reducing the risk of complications following inguinal hernia repair. In settings where surgical delays are common, improving access to care, streamlining surgical scheduling, and expanding the availability of minimally invasive techniques could significantly enhance patient outcomes. These findings support policy efforts aimed at optimizing surgical care pathways and reducing avoidable delays.