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

Authors

  • 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

Keywords:

Inguinal hernia, Herniorrhaphy, Reoperation rate, Mesh repair, Tissue repair, Loss to follow-up

Abstract

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.

References

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.

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Published

2011-03-31

How to Cite

1.
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 2024 Apr. 20];32(1):13-20. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/249030

Issue

Vol. 32 No. 1 (2011): January - March

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.