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Low complication rate and an increasing incidence of surgical repair of primary indirect sliding inguinal hernia

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Abstract

Purpose

The purpose of the present study was to explore the risk for complications and reoperations following open repairs for sliding groin hernias.

Method

All primary indirect inguinal hernia repairs registered in the Swedish Hernia Register 1998–2011 were identified. Repeated and bilateral procedures were excluded. The epidemiology, the incidence of per- and postoperative complications, and the reoperation rate due to recurrences were analyzed.

Results

100 240 non-repeated unilateral repairs were registered with sliding hernias in 13 132 (13.1 %) (male 14 %, female 5 %) procedures. The methods of repair for sliding and non-sliding hernias were Lichtenstein and other open anterior mesh repairs (N = 10865, 82.7 % and N = 60790, 69.8 %), endoscopic techniques (N = 136, 1.0 % and N = 4352, 5.0 %), and other techniques (N = 2131, 16.2 % and N = 21966, 25.2 %). In multivariate analyses with adjustment for gender, acute/planned surgery, reducibility, method of repair and age, sliding hernias were associated with a low but slightly increased risk for perioperative complications (hazard ratio 1.30, 95 % confidence interval 1.04–1.62, p = 0.023) and postoperative hematoma (hazard ratio 1.13, confidence interval 1.02–1.26, p = 0.019). There was no increased risk of reoperation due to recurrences.

Conclusion

Compared to older reports, the incidence of repairs due to primary indirect sliding inguinal hernias has increased over time and it is not just a male disease. The overall results are good with low and comparable complication rates, and no increased risk of reoperations due to recurrences.

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Acknowledgments

The authors would like thank all Swedish groin hernia surgeons who assembled the data in the SHR. Presented in part as an abstract and a speech at the Swedish Surgical Society, 17th Surgical week, Linköping, Sweden, August 20–24, 2012.

Author’s contributions

Gabriel Sandblom, Dan Sevonius, and Magnus Hallén designed the study.

Henrik Holmberg was responsible for data acquisition and analysis.

Magnus Hallén drafted the manuscript together with Gabriel Sandblom and Dan Sevonius.

Author information

Authors and Affiliations

  1. Department of Surgery, Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85, Lund, Sweden

    Magnus Hallén & Dan Sevonius

  2. Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

    Henrik Holmberg

  3. CLINTEC, Division of Surgery, Karolinska Institute, 141 86, Stockholm, Sweden

    Gabriel Sandblom

Authors
  1. Magnus Hallén
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  2. Dan Sevonius
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  3. Henrik Holmberg
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  4. Gabriel Sandblom
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Corresponding author

Correspondence to Gabriel Sandblom.

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Conflict of interest

The SHR is supported financially by the National Board of Health and Welfare, the Swedish Association of Local Authorities, and the County Council of Jämtland. This study was supported by grants from the Anders Borgström Fellowship and the Olle Engqvist Research Foundation. The authors declare no other conflicts of interest.

Research involving human participants and/or animals

All procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. The study was approved by the Umeå Ethics Review Board.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Hallén, M., Sevonius, D., Holmberg, H. et al. Low complication rate and an increasing incidence of surgical repair of primary indirect sliding inguinal hernia. Langenbecks Arch Surg 401, 215–222 (2016). https://doi.org/10.1007/s00423-016-1392-5

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  • DOI: https://doi.org/10.1007/s00423-016-1392-5

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