Reoperation Rates after Inguinal Herniorrhaphy: A 10-year Review at a Tertiary Care Hospital
Keywords:Inguinal hernia, Herniorrhaphy, Reoperation rate, Mesh repair, Tissue repair, Loss to follow-up
Objective: To estimate the reoperation rates for various inguinal hernia repairs using appropriate statistical methods, and to assess the effects of losses to follow up on these rates.
Methods: Medical charts of patients who underwent elective herniorrhaphy during January 1998 to December 2007 were reviewed. Cumulative reoperation rates were estimated using the Nelson-Aalen method.
Results: There were 1,852 hernia operations on 1,533 patients. There were 1,697 (92%) primary and 155 (8%) secondary hernias. Of these, 1,207 (65%) were tissue-based repairs and 645 (35%) were mesh-based repairs, of which 152 (8%) were laparoscopic repairs. There were 94 reoperations and 57% (981/1,727) loss to follow-up. The estimated overall reoperation rates were 17.4%, 27.8%, and 60.9% at 3, 5, and 10 years, respectively. Assuming complete 10-year follow-up for those lost to follow-up yielded reoperation rates of 4.9%, 6.1% and 7,1% at 3, 5, and 10 years respectively. Mesh-based repairs had slightly fewer reoperations than tissue-based repairs for primary hernias. Laparoscopic repairs had a slightly higher reoperation rate than open mesh repairs.
Conclusion: The reoperation rates in the present study were overestimated due to a high proportion of losses to follow-up. Mesh-based repairs including laparoscopic repairs did not differ significantly from tissue-based repairs in terms of reoperations.
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