# Ambulatory inguinal hernia repair in Portugal - a multicenter prospective cohort study **Authors:** Alice Pimentel, Alice Pimentel, Teresa Santos, Sofia Dias da Silva, Lúcia Carvalho, Ana Luísa Pinto Frutuoso, Rita Matias, Leonor Matos, Filipe Almeida, Fabiola Amado, Alexandra Ferreira, Isabel Martins, Estanislau Mateia, Vanessa Praxedes, Joana Seabra, Xavier de Sousa, André Silva, Márcia Carvalho, João Mendes, Carlos Macedo Oliveira, Francisco Girão de Caires, Ana Luísa Rodrigues, Regina Silva, Rui Lacerda Cunha, Ana Rita de Sousa Marinho Falcão, Ester Ferreira, Carla Menezes, Inês Neri, Rafael de Castro Nobre, Ana de Clamouse Rebelo, Pedro Santos, David Ferra de Sousa, Ana Andrade, Inês Barros, Sofia Frade, João Gomes, Inês Nunes, Sofia Pina, Nádia Silva, Rui Sousa, Aldara Faria, Ana Gomes, Carlota Ramos, Vanessa Santos, Catarina Antão, Luís Castro, Joana Ferreira, Inês Lima, Filipa Policarpo, Sara Ramtula, Joana Romano, Sara Silveira, Joana Romano, Nuno Rombo, Francisco Baeta, Ana Sofia Boligo, Diogo Cardoso, Vasco S. Cardoso, Claúdia Figueiredo, Isabela Gil, Ana Rita Monte, Joana Romano, Constança M. Azevedo, Rui Cunha, Filipa Dias Mendes, Miguel Semião, Ana Almeida, Maria João Amaral, André Amaro, Andreia Guimarães, Catarina Lopes, Oriana Nogueira, Eva Santos, Marta Rodrigues da Silva, Vítor Devezas, Telma Fonseca, Fábio Gomes, Joana Mafalda Monteiro, António Pereira-Neves, Jorge Nogueiro, Mariana Canelas-Pais, André Pereira, Fernando Resende, Sara Rodrigues, Edgar Amorim, Beatriz Dias, Victor Hugo Baptista, João Melo, Inês Miguel, Juan Rachadell, Antonio Rivero, Liliana Sequeira, Diogo Veiga, Andreia Branco, Inês Costa Carvalho, Barbara Castro, Sofia Fonseca, Raquel Prata Saraiva, Tatiana Queirós, Ana Rita, Alexandra Campos da Silva, Inês Teixeira, Ana Paula Torre, Cátia Cunha, Marisa Peralta Ferreira, Pedro Miranda, Ana M. Cabral, Bárbara Nunes Gama, Catarina dos Santos Rodrigues, Nisalda Carla Melo Rosa, Diogo Galvão, Anaísa Silva, Ana Cláudia Soares, Bárbara Vieira, Ana Couceiro, Marta Ferreira, Narcisa Guimarães, Inês Mónica, Simone Oliveira, Daniela Pais, Hugo Ribeiro, Renato Barradas, Sónia Martins, Miguel Almeida, Ana Faustino, António Freitas, Ana Beatriz Martins, Catarina Moura, Rafaela Parreira, Joana Bolota, Ana Margarida Monteiro Cinza, Sofia Leandro, Rita Lima, Joana Oliveira, Mário Pereira, Miguel Rocha Melo, Cristina Velez, Adalberto Cardoso, Mariana Claro, Ana Cláudia Deus, Andreia Ferreira, Hugo Gameiro, Diogo Marinho, Daniel Costa Santos, Alberto Abreu da Silva, Sara Rodrigues Silva, Diogo Sousa, Ana Lúcia Preto Barreira, Filipe Borges, Pedro Silva Pereira Sousa Botelho, Brigitta Cismasiu, Margarida Silva Ferreira, Susana Henriques, José Guilherme Nobre, Maria Francisca Rodrigues de Areia Brito Da Silva, Ricardo Manuel Branco Souto, César Carvalho, Filipe Guerra, Inês Guerreiro, Paulo Sousa, Filipe André Ramalho de Almeida, David Aparício, Inês Rita Capunge, Rita Marques de Sá Carmarneiro, Jorge Cristo, Marta Fragoso, Joana Frazão, João Guimarães, Ana Rita Martins, Rita Ribeiro Reis Vale Martins, Maria de Jesus Oliveira, João Silva Ribeiro, Paula Soraya de Carvalho e Azevedo Teixeira, Telma Rodrigues Brito, Diana Carina Lima Gomes, Mariana Silva Leite, Carolina Matos, Cristina Ferreira Monteiro, Diogo Abel Vasconcelos Nogueira Pinto, Cristina Silva, Bruno Ribeiro da Silva, Carina Baldino, Ana Guerreiro, Maria Jervis, André Pacheco, Valter Paixão, Vera Pedro, Joana Marantes Pimenta, Filipa Narciso Rocha, Manuela Mega, Rita Monteiro, Joana Peliteiro, Manuela Romano, Alexandra Soares, Mafalda Sampaio-Alves, Natacha Alves, Gabriel Costa, Lígia Freire, José Pedro Gonçalves, Tatiana Marques, Francisco Marrana, Sara Marques, Diogo Melo Pinto, Catarina Quintela, Evgeniya Sitchikhina, Pedro Valente, João Miguel Carvas, Maria Inês Durães, Guida Pires, Carlos Pires, Joana Gomes da Silva, Miguel Brito, Hugo Capote, Cristina Costa, Guilherme Fialho, Tamiris Mogne, Sara Morais, Beatriz Mourato, David Salvador, Coral Aguero, Joaquina Dominguez, Miguel Angel Fernandez, Carlos Figueiredo, Monica Guerrero, Manuel Neuparth, Marta Reia PMC · DOI: 10.1007/s13304-025-02084-6 · 2025-03-25 ## TL;DR This study in Portugal found no significant difference in complication rates between ambulatory and inpatient inguinal hernia repair, suggesting ambulatory surgery is safe for eligible patients. ## Contribution The study provides new evidence on the safety of ambulatory inguinal hernia repair in a Portuguese population. ## Key findings - No significant difference in complication rates between ambulatory and inpatient surgery. - Ambulatory surgery was performed in 52.2% of patients without increased complication risk. ## 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. The online version contains supplementary material available at 10.1007/s13304-025-02084-6. ## Full-text entities - **Diseases:** hernias (MESH:D006547), inguinal hernia (MESH:D006552) - **Species:** Homo sapiens (human, species) [taxon 9606] ## Figures 5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12630251/full.md --- Source: https://tomesphere.com/paper/PMC12630251