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Impact of age on groin hernia profiles observed during laparoscopic transabdominal preperitoneal hernia repair

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Abstract

Background

How increasing age affects the characteristics of groin hernia remains uncertain. This study evaluated the association between age and the type of groin hernia, especially with respect to its multiplicity, observed during laparoscopic transabdominal preperitoneal (TAPP) hernia repair.

Methods

We retrospectively evaluated 634 consecutive patients with primary groin hernia who underwent laparoscopic TAPP repair between October 2000 and June 2017. Patients were stratified into 4 age groups: < 60 years, 60–69 years, 70–79 years, and 80 years or older.

Results

The incidence of occult contralateral hernia and multiple ipsilateral hernias increased significantly with each increasing age group: 7.3%, 10.4%, 12.7%, and 20.8% for occult contralateral hernia (p = 0.005), and 5.6%, 9.2%, 16.8%, and 21.7% for multiple ipsilateral hernias (p < 0.001), respectively. Univariate analyses showed that an older age (age ≥ 70 years) was the only factor significantly associated with the presence of multiple groin hernias (odds ratio, 2.69; 95% confidence interval, 1.89–3.81; p < 0.001). In patients with multiple ipsilateral hernias, the prevalent form in men was a pantaloons hernia, with an incidence of about 70% across all age groups, whereas in women it was groin hernias, with one component being a femoral hernia, an obturator hernia, or both.

Conclusions

The multiple occurrence of groin hernias, either unilaterally or bilaterally, was a clinical feature in the elderly.

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References

  1. Ruhl CE, Everhart JE (2007) Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol 165:1154–1161

    Article  PubMed  Google Scholar 

  2. Rosemar A, Angeras U, Rosengren A (2008) Body mass index and groin hernia: a 34-year follow-up study in Swedish men. Ann Surg 247:1064–1068

    Article  PubMed  Google Scholar 

  3. Burcharth J, Pedersen M, Bisgaard T, Pedersen C, Rosenberg J (2013) Nationwide prevalence of groin hernia repair. PLoS ONE 8:e54367

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Wagh PV, Leverich AP, Sun CN, White HJ, Read RC (1974) Direct inguinal herniation in men: a disease of collagen. J Surg Res 17:425–433

    Article  CAS  PubMed  Google Scholar 

  5. Pallati PK, Gupta PK, Bichala S, Gupta H, Fang X, Forse RA (2013) Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians. Hernia 17:723–727

    Article  CAS  PubMed  Google Scholar 

  6. Abrahamson J (1998) Etiology and pathophysiology of primary and recurrent groin hernia formation. Surg Clin North Am 78:953–972, vi

    Article  CAS  PubMed  Google Scholar 

  7. Lau H, Fang C, Yuen WK, Patil NG (2007) Risk factors for inguinal hernia in adult males: a case-control study. Surgery 141:262–266

    Article  PubMed  Google Scholar 

  8. Nations U (2017) World population prospects: the 2017 revision

  9. Panton ON, Panton RJ (1994) Laparoscopic hernia repair. Am J Surg 167:535–537

    Article  CAS  PubMed  Google Scholar 

  10. Evans DS, Ghaneh P, Khan IM (1996) Day-case laparoscopic hernia repair. Br J Surg 83:1361–1363

    Article  CAS  PubMed  Google Scholar 

  11. Sayad P, Abdo Z, Cacchione R, Ferzli G (2000) Incidence of incipient contralateral hernia during laparoscopic hernia repair. Surg Endosc 14:543–545

    Article  CAS  PubMed  Google Scholar 

  12. Koehler RH (2002) Diagnosing the occult contralateral inguinal hernia. Surg Endosc 16:512–520

    Article  CAS  PubMed  Google Scholar 

  13. O’Rourke A, Zell JA, Varkey-Zell TT, Barone JL, Bayona M (2002) Laparoscopic diagnosis and repair of asymptomatic bilateral inguinal hernias. Am J Surg 183:15–19

    Article  PubMed  Google Scholar 

  14. Bochkarev V, Ringley C, Vitamvas M, Oleynikov D (2007) Bilateral laparoscopic inguinal hernia repair in patients with occult contralateral inguinal defects. Surg Endosc 21:734–736

    Article  CAS  PubMed  Google Scholar 

  15. Novitsky YW, Czerniach DR, Kercher KW, Kaban GK, Gallagher KA, Kelly JJ, Heniford BT, Litwin DE (2007) Advantages of laparoscopic transabdominal preperitoneal herniorrhaphy in the evaluation and management of inguinal hernias. Am J Surg 193:466–470

    Article  PubMed  Google Scholar 

  16. Griffin KJ, Harris S, Tang TY, Skelton N, Reed JB, Harris AM (2010) Incidence of contralateral occult inguinal hernia found at the time of laparoscopic trans-abdominal pre-peritoneal (TAPP) repair. Hernia 14:345–349

    Article  CAS  PubMed  Google Scholar 

  17. Pawanindra L, Philips P, Chander J, Ramteke VK (2010) Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair. Surg Endosc 24:1737–1745

    Article  Google Scholar 

  18. van den Heuvel B, Beudeker N, van den Broek J, Bogte A, Dwars BJ (2013) The incidence and natural course of occult inguinal hernias during TAPP repair: repair is beneficial. Surg Endosc 27:4142–4146

    Article  PubMed  Google Scholar 

  19. Wu CC, Chueh SC, Tsai YC (2016) Is contralateral exploration justified in endoscopic total extraperitoneal repair of clinical unilateral groin hernias—a prospective cohort study. Int J Surg 36:206–211

    Article  PubMed  Google Scholar 

  20. Ekberg O, Lasson A, Kesek P, van Westen D (1994) Ipsilateral multiple groin hernias. Surgery 115:557–562

    CAS  PubMed  Google Scholar 

  21. Ramshaw B, Shuler FW, Jones HB, Duncan TD, White J, Wilson R, Lucas GW, Mason EM (2001) Laparoscopic inguinal hernia repair: lessons learned after 1224 consecutive cases. Surg Endosc 15:50–54

    Article  CAS  PubMed  Google Scholar 

  22. HerniaSurge G (2018) International guidelines for groin hernia management. Hernia 22:1–165

    Article  Google Scholar 

  23. Thumbe VK, Evans DS (2001) To repair or not to repair incidental defects found on laparoscopic repair of groin hernia: early results of a randomized control trial. Surg Endosc 15:47–49

    Article  CAS  PubMed  Google Scholar 

  24. Lilly MC, Arregui ME (2002) Lipomas of the cord and round ligament. Ann Surg 235:586–590

    Article  PubMed  PubMed Central  Google Scholar 

  25. Nasr AO, Tormey S, Walsh TN (2005) Lipoma of the cord and round ligament: an overlooked diagnosis? Hernia 9:245–247

    Article  PubMed  Google Scholar 

  26. Henriksen NA, Thorup J, Jorgensen LN (2012) Unsuspected femoral hernia in patients with a preoperative diagnosis of recurrent inguinal hernia. Hernia 16:381–385

    Article  CAS  PubMed  Google Scholar 

  27. Abramson JH, Gofin J, Hopp C, Makler A, Epstein LM (1978) The epidemiology of inguinal hernia. A survey in western Jerusalem. J Epidemiol Community Health 32:59–67

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ (1997) Risk factors for inguinal hernia in women: a case-control study. The Coala trial group. Am J Epidemiol 146:721–726

    Article  CAS  PubMed  Google Scholar 

  29. Zendejas B, Hernandez-Irizarry R, Ramirez T, Lohse CM, Grossardt BR, Farley DR (2014) Relationship between body mass index and the incidence of inguinal hernia repairs: a population-based study in Olmsted County. MN Hernia 18:283–288

    Article  CAS  PubMed  Google Scholar 

  30. Glassow F (1985) Femoral hernia. Review of 2,105 repairs in a 17 year period. Am J Surg 150:353–356

    Article  CAS  PubMed  Google Scholar 

  31. Andresen K, Bisgaard T, Kehlet H, Wara P, Rosenberg J (2014) Reoperation rates for laparoscopic versus open repair of femoral hernias in Denmark: a nationwide analysis. JAMA Surg 149:853–857

    Article  PubMed  Google Scholar 

  32. Bjork KJ, Mucha P Jr, Cahill DR (1988) Obturator hernia. Surg Gynecol Obstet 167:217–222

    CAS  PubMed  Google Scholar 

  33. Ziegler DW, Rhoads JE Jr (1995) Obturator hernia needs a laparotomy, not a diagnosis. Am J Surg 170:67–68

    Article  CAS  PubMed  Google Scholar 

  34. Skandalakis LJSP, Gray SW (1995) Hernia. In: Nyhus LMCR (ed) Hernia O, J.B. Lippincott, Philadelphia, pp 425–439

    Google Scholar 

  35. Koch A, Edwards A, Haapaniemi S, Nordin P, Kald A (2005) Prospective evaluation of 6895 groin hernia repairs in women. Br J Surg 92:1553–1558

    Article  CAS  PubMed  Google Scholar 

  36. Yokoyama T, Kobayashi A, Kikuchi T, Hayashi K, Miyagawa S (2011) Transabdominal preperitoneal repair for obturator hernia. World J Surg 35:2323–2327

    Article  PubMed  Google Scholar 

  37. Gray SW, Skandalakis JE, Soria RE, Rowe JS Jr (1974) Strangulated obturator hernia. Surgery 75:20–27

    CAS  PubMed  Google Scholar 

  38. Donahue PE (1995) Hernia. In: Nyhus LMCR (ed) Theoretic aspects of hernia. J.B. Lippincott, Philadelphia, pp 73–82

    Google Scholar 

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Authors and Affiliations

  1. First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan

    Kentaro Fukushima, Takahide Yokoyama, Hiroaki Motoyama, Akira Shimizu, Tsuyoshi Notake, Akira Kobayashi & Shin-ichi Miyagawa

  2. Department of Surgery, Okaya Municipal Hospital, Okaya, Japan

    Shiro Miwa, Takuma Arai & Noriyuki Kitagawa

  3. Department of Surgery, Showa-inan General Hospital, Komagane, Japan

    Toshiki Kikuchi

Authors
  1. Kentaro Fukushima
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  2. Takahide Yokoyama
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Correspondence to Akira Kobayashi.

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Kentaro Fukushima, Takahide Yokoyama, Shiro Miwa, Hiroaki Motoyama, Takuma Arai, Noriyuki Kitagawa, Akira Shimizu, Tsuyoshi Notake, Toshiki Kikuchi, Akira Kobayashi, and Shin-ichi Miyagawa have no conflicts of interest or financial ties to disclose.

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Fukushima, K., Yokoyama, T., Miwa, S. et al. Impact of age on groin hernia profiles observed during laparoscopic transabdominal preperitoneal hernia repair. Surg Endosc 33, 2602–2611 (2019). https://doi.org/10.1007/s00464-018-6556-7

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  • DOI: https://doi.org/10.1007/s00464-018-6556-7

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