Proportion of femoral hernia repairs performed for recurrence in the United States
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Recurrence rates after femoral hernia repair (FHR) have not been reliably established in the USA. We sought to determine this trend over time.
The proportion of primary and recurrent FHRs was determined for patients age ≥ 18 from: ACS-NSQIP (1/2005–12/2014), Premier (1/2010–09/2015), and institutional (1/2005–12/2014) data. Trends were analyzed using a one-tailed Cochran–Armitage test.
In the NSQIP database, 6649 patients underwent a FHR. In females, the proportion of FHRs performed for recurrence decreased from 14.0% in 2005 to 6.2% in 2014, p = 0.02. In males, there was no change: 16.7–16.1% 2005–2014 (p = 0.18). The Premier database included 4495 FHRs and our institution 315 FHRs. There was no difference for either gender over time in either data source, all p > 0.05.
The proportion of femoral hernia repairs performed for recurrence in the USA remained relatively constant in males in two large national databases between 2005 and 2015. In females, a decrease was seen in one of the large national databases.
KeywordsFemoral hernia repair Recurrence NSQIP Premier
The authors would like to acknowledge and thank the Mayo Clinic Department of Surgery, the Kern Center for the Science of Health Care Delivery, and Medtronic as substantial contributors of resources to this project.
The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery provides salary support for Dr. Habermann, Dr. Murphy, and Mr. Ubl. Dr. Jianying Zhang is an employee of Medtronic and provided the analysis of the Premier Database. No external funding was used. This work was presented as an e-poster presentation at the Southwest Surgical Congress Annual Meeting in Maui, Hawaii April 2017.
Compliance with ethical standards
Conflicts of interest
BM declares no conflict of interest DU declares no conflict of interest. JZ declares no conflict of interest. EH declares no conflict of interest. DF declares no conflict of interest. KP declares no conflict of interest.
The authors have no conflicts of interest to disclose. Dr. Zhang is an employee of Medtronic and completed the analysis of the Premier database. We teamed with Medtronic to help perform the statistical analyses of the Premier database due to their expertise in analyzing this extensive data source. Medtronic shared in our goals of identifying the current state of hernia repairs in the United States as a whole and offered to partner with us for this study. Dr. Zhang performed the statistical analysis of the Premier data, which was critically evaluated and discussed among all authors. All authors were involved in data interpretation. Our agreement with Medtronic precluded financial considerations for this project.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Human and animal rights
This article does not contain any studies with animals performed by any of the authors.
For this type of study formal consent is not required.