The relationship between preoperative neutrophil-to-lymphocyte ratio and early postoperative clinical outcomes following laparoscopic inguinal hernia repair: A retrospective analysis
Burak Sakar1, Ali Celik2, Arzu Karaveli3, Nedim Akgül21Department of General Surgery, Bozkır State Hospital, Konya, Türkiye2Department of General Surgery, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye
3Department of Anesthesiology and Reanimation, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye
INTRODUCTION: This study aimed to evaluate the impact of preoperative neutrophil-to-lymphocyte ratio (NLR) levels on early postoperative clinical outcomes in patients undergoing laparoscopic inguinal hernia repair using the Transabdominal Preperitoneal (TAPP) technique.
METHODS: In this single-center retrospective study, data from 93 patients who underwent surgery using the TAPP technique between June 2022 and December 2024 were analyzed. The patients were divided into two groups based on their preoperative NLR: ≤2 (Low NLR, n=51) and >2 (High NLR, n=42). The primary endpoint of the study was to compare the postoperative 6th-hour Visual Analog Scale (VAS) scores between the groups. Secondary endpoints included postoperative VAS scores at 24 h, 10 days, and 3 months, rescue analgesic consumption, the time to return to daily life/work.
RESULTS: The mean postoperative 6th-hour VAS score was significantly lower in the Low NLR group than in the High NLR group (p=0.006). Similarly, the mean 24th-hour VAS scores were significantly lower in the Low NLR group (p=0.022). However, the mean VAS scores on the 10th postoperative day and at 3 months were comparable between the groups (p=0.274 and p=0.104, respectively). Mean rescue analgesic consumption was significantly lower in the Low NLR group than in the High NLR group (p=0.005). The median time to return to daily life/work was shorter in the Low NLR group (p<0.001).
DISCUSSION AND CONCLUSION: A higher preoperative NLR is associated with greater early postoperative pain, higher analgesic consumption and delayed return to daily life/work after laparoscopic inguinal hernia repair. NLR may serve as a biomarker for predicting postoperative pain and recovery, although larger prospective studies are needed for validation.
Keywords: Inguinal Hernia, laparoscopy, preoperative, neutrophil-to-lymphocyte ratio
Manuscript Language: English