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High complication rates during and after repeated Lichtenstein or laparoscopic inguinal hernia repairs in the same groin: a cohort study based on medical records

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Abstract

Purpose

Performing two anterior or two posterior inguinal hernia repairs in the same groin contradict guidelines. Nevertheless, there can be indications for using the same approach at reoperation, and information on complications other than the risk of a third repair and chronic pain is lacking in the literature. The aim was to assess intraoperative events and postoperative complications after two Lichtenstein repairs or laparoscopic inguinal hernia repairs in the same groin.

Methods

This nationwide cohort study included patients that had received two Lichtenstein repairs (Lichtenstein–Lichtenstein) or two laparoscopic (Laparoscopy–Laparoscopy) inguinal hernia repairs in the same groin. Patients were identified in the Danish Hernia Database and outcomes were identified in medical records during a period of 6 years. Outcomes were intraoperative events that deviated from a standard repair and 1-year postoperative complications classified according to the Clavien–Dindo classification. Outcomes were reported separately for the two cohorts.

Results

Among the included 102 Lichtenstein reoperations, 27% of the repairs had intraoperative events, with drain placement being most common (10%). Half of the reoperations resulted in complications where infection (15%) and hematoma (12%) were most frequent. Among the 58 laparoscopic reoperations, 16% had an intraoperative event where bleeding requiring clips was most common (10%). Half of the reoperations resulted in a complication with surgery in general anesthesia in the same groin area being the most frequent complication (9%).

Conclusions

Intraoperative events and 1-year postoperative complications were high for both Lichtenstein–Lichtenstein and Laparoscopy–Laparoscopy, and the results therefore support guidelines that recommend another approach at reoperation.

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Funding

This study received no financial support from extramural sources.

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Authors and Affiliations

  1. Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark

    S. Öberg, M. L. Jessen, K. Andresen & J. Rosenberg

  2. Steering committee, Danish Hernia Database, Copenhagen, Denmark

    K. Andresen & J. Rosenberg

  3. Department of Surgery, Zealand University Hospital, Køge, Denmark

    J. V. Rothman

Authors
  1. S. Öberg
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  2. M. L. Jessen
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  3. K. Andresen
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  4. J. V. Rothman
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  5. J. Rosenberg
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Correspondence to S. Öberg.

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Conflicts of interest

Öberg reports no potential conflicts of interest. Jessen reports no potential conflicts of interest. Andresen reports no potential conflicts of interest. Rothman reports no potential conflicts of interest. Rosenberg reports personal fees from Bard and Merck, outside the submitted work.

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For this type of study, ethical approval was not required

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Öberg, S., Jessen, M.L., Andresen, K. et al. High complication rates during and after repeated Lichtenstein or laparoscopic inguinal hernia repairs in the same groin: a cohort study based on medical records. Hernia 24, 801–810 (2020). https://doi.org/10.1007/s10029-019-02083-8

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  • DOI: https://doi.org/10.1007/s10029-019-02083-8

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