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Intestinal obstruction after inguinal and femoral hernia repair: a study of 33,275 operations during 1992–2000 in Sweden

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Abstract

The risk of intra-abdominal intestinal obstruction after open or laparoscopic hernioplasty is, to our knowledge, not known. The transabdominal laparoscopic (TAPP) route brings a potential risk of abdominal adhesions, which may increase the risk of postoperative intestinal obstruction. The pre-peritoneal route laparoscopically, totally extraperitoneal laparoscopic hernioplasty (TEP), should not increase this risk since the abdominal cavity is not entered. The Swedish Hernia Register, with 33,275 patients operated on for single primary unilateral groin hernia during the period 1992–2000, was linked to the Swedish Inpatient register and the Swedish Death register for the period 1987–2000. The risk of postoperative intestinal obstruction was low, 1.02 per 1,000 personyears. The highest adjusted relative risks (RR) were found in patients with previous admissions for abdominal inflammations or operations. The risk increased with the number of admissions. After an acute operation, and in patients older than 60 years, there was also a significantly increased risk. The RR was 2.79 (95% CI 1.01–7.42) after TAPP and 0.57 (95% CI 0.07–4.33) following TEP compared to patients operated on by the Lichtenstein method. None of the patients undergoing open hernia operations had a significantly increased risk. TAPP increased the risk of postoperative intestinal obstruction, but other risk factors, especially previous abdominal surgery or inflammation, have greater influence.

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Acknowledgements

The authors acknowledge SHR surgeons for their collaboration. The SHR has been assembled by representatives from the following surgical units: Arvika, Bollnäs, Eksjö, Eskilstuna, Falköping, Falun, Finspång, Gällivare, Gävle, Frölunda (Göteborg), Lundby (Göteborg), Sahlgrenska University Hospital (Göteborg), Helsingborg, Hudiksvall, Jönköping, Kalix, Kalmar, Karlshamn, Karlskoga, Karlskrona, Katrineholm, Kristianstad-Hässleholm, Lidköping, Lindesberg, Linköping University Hospital, Ljungby, Ludvika, Lund-Landskrona, Lycksele, Mora, Motala, Norrköping, Norrtälje, Oskarshamn, Piteå, Skellefteå, Skene, Ersta (Stockholm), Huddinge University Hospital (Stockholm), S:t Göran (Stockholm), Säffle, Södertälje, Trollhättan, Uddevalla, Uppsala, Varberg, Värnamo, Västervik, Läkargruppen (Örebro) and Östersund. Statistician Lennart Gustafsson has provided invaluable help during the preparation of this manuscript. Financial support for the Swedish Hernia Register has been received from the National Board of Health and Welfare and the Federation of County Councils of Sweden. The study was supported by a grant from the County Council of Stockholm. The authors did not have any conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Södertälje Hospital, SE-152 86 , Södertälje, Sweden

    S. Bringman

  2. Center for Surgical Sciences, Karolinska Institutet at Huddinge University Hospital

    S. Bringman

  3. Medical Epidemiology and Biostatistics and Unit of Clinical Epidemiology, Department of Medicine at Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden

    P. Blomqvist

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  1. S. Bringman
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Correspondence to S. Bringman.

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Bringman, S., Blomqvist, P. Intestinal obstruction after inguinal and femoral hernia repair: a study of 33,275 operations during 1992–2000 in Sweden. Hernia 9, 178–183 (2005). https://doi.org/10.1007/s10029-004-0305-7

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  • DOI: https://doi.org/10.1007/s10029-004-0305-7

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