Reoperation Rates after Inguinal Herniorrhaphy: A 10-year Review at a Tertiary Care Hospital


  • Suragit Pornchai Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Ronnarat Suvikapakornkul Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Panuwat Lertsithichai Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand


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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1. Matthews RD, Neumayer L. Inguinal hernia in the 21st century: and evidence-based review. Curr Probl Surg 2008; 45:261-312.

2. Bay-Nielsen M. Kehlet H, Strand L. Maimstrom J. Heide Andersen F, Wara P, Callesen T, for the Danish Hernia Database Collaboration. Quality assessment of 26 304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 2001; 358:1124-8.

3. Nixon SJ, Jawaid H. Recurrence after inguinal hernia repair at ten years by open darn, open mesh and TEP – no advantage with mesh. Surgeon 2009; 7:71-4.

4. Klein JP, Moeschberger ML. Survival analysis: techniques for censored and truncated data. New York: Springer-Verlag; 1997. p.416-7.

5. Nyhus LM, editor. Symposium on hernias. Surg Clin N Am 1984; 64:185-422.

6. Nilsson E, Haapaniemi. Hernia registers and specialization. In: Rutkow IM, editor. Groin hernia surgery, Surg Clin N Am 1998; 78:1141-55.

7. Kux M. Bassini versus Shouldice: original methods and physiologic variants. In: Nyhus LM, Condon RE, editors. Hernia. 4th ed. Philadelphia: JB Lippincott Co; 1995. p.234-5.

8. Welsh DRJ, Alexander MAJ. The Shouldice repair. In: Rutkow IM, editor, Hernia surgery. Surg Clin N Am 1993; 73:451-69.

9. Sevonius D, Gunnarsson U. Nordin P, Nilsson E, Sandblom G. Repeated groin hernia recurrences. Ann Surg 2009; 249:516-8.

10. Wara P, Bay-Nielsen M, Juul P, Bendix J, Kehlet H. Prospective nationwide analysis of laparoscopic versus Lichtenstein repair of inguinal hernia. Br J Surg 2005; 92:1277-81.

11. Itani KMF, Duh QY. Management of recurrent inguinal hernias. J Am Coll Surg 2009; 209:653-8.

12. Malangoni MA, Gagliardi RJ, Hernias. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston's textbook of surgery. 17th ed. Philadelphia: Elsevier-Saunders; 2004. p.1215.

13. Pokorny H, Klinger A, Schmid T, Fortelny R, Hollinsky C, Kawji R, et al. Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia 2008; 12:385-9.

14. Bisgaard T, Bay-Nielsen M, Christensen IJ, Kehlet H. Risk of recurrence 5 years or more after primary Lichtenstein mesh and sutured inguinal hernia repair. Br J Surg 2007; 94:1038-40.

15. McCormack K, Scott N, Go PM, Grant A, Collaboration of the EU Hernia Trialists. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003; 1: CD001785.

16. Richards SK, Vipond MN, Earnshaw JJ. Review of the management of recurrent inguinal hernia. Hernia 2004; 8:144-8.

17. Neumayer L, Giobbie-Hurder A, Jonasson O, Flitzgibbons R, Dunlop D, Gibbs J, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 2004; 350:1819-27.




How to Cite

Pornchai S, Suvikapakornkul R, Lertsithichai P. Reoperation Rates after Inguinal Herniorrhaphy: A 10-year Review at a Tertiary Care Hospital. Thai J Surg [Internet]. 2011 Mar. 31 [cited 2022 Aug. 15];32(1):13-20. Available from:



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