Causes of recurrences after open inguinal herniorrhaphy

Ashrafi, Darius; Siddaiah‐Subramanya, Manjunath; Memon, Breda; Memon, Muhammed Ashraf

doi:10.1007/s10029-018-1868-z

Cited by 29 publications

(29 citation statements)

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“…Although MMPs may have a role to play in the recurrence of inguinal hernia, (Antoniou et al, , ) we did not analyze the association between dementia and inguinal hernia recurrence because several modifiable and nonmodifiable contributors to hernia recurrence including perioperative (e.g., the surgeon—learning curve and caseload), patient (age, body mass index), and hernia (e.g., direct inguinal hernias vs. indirect inguinal hernias) factors have been reported (Ashrafi, Siddaiah‐Subramanya, Memon, & Memon, ). Besides, taking into account the limited sample size of our study, an estimated rate of 13% for surgical repair of recurrent inguinal hernias among all inguinal hernia operations (Ashrafi et al, ) would further diminish the study population and blemish the accuracy of risk assessment. Additionally, despite being a common clinical observation, the association between increase in abdominal pressure (e.g., chronic cough and constipation) and the development of hernias remains controversial (Ruhl, ).…”

Section: Discussionmentioning

confidence: 99%

“…The major strength of the current investigation was the utilization of a nationwide population-based database as well as the longi- (Ashrafi, Siddaiah-Subramanya, Memon, & Memon, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Besides, taking into account the limited sample size of our study, an estimated rate of 13% for surgical repair of recurrent inguinal hernias among all inguinal hernia operations (Ashrafi et al, 2019) would further diminish the study population and blemish the accuracy of risk assessment. Additionally, despite being a common clinical observation, the association between increase in abdominal pressure (e.g., chronic cough and constipation) and the development of hernias remains controversial (Ruhl, 2007).…”

Section: Discussionmentioning

confidence: 99%

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Association between abdominal hernia and the risk of subsequent dementia

et al. 2019

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ObjectiveMatrix metalloproteinases (MMPs) may play a role in the pathophysiology of neurodegenerative disease and hernia formation. This retrospective cohort study was designed to assess whether there is an association between hernia and the risk of dementia.Materials and MethodsPatients (≥45 years) with hernias were identified between 2000 and 2008 from a longitudinal claims data of one million beneficiaries from Taiwan's National Health Insurance program. A control group of patients with comparable distributions of sex, age, socioeconomic status, urbanization, and medical comorbidities without hernia were chosen for matching in a ratio of 1:1. Patients previously diagnosed with dementia were excluded. Follow‐up ended on December 31, 2013. Incidence rate of dementia was compared between patients with hernias and those without. Cox proportional hazards models were used to estimate hazards relative to those of the control group.ResultsAfter matching, there were 4,784 hernia and 4,784 nonhernia patients. Hernia patients showed a higher incidence rate and hazard ratio of dementia than those in nonhernia group (8.82 vs. 7.19/1,000 person‐years; adjusted hazard ratio [aHR], 1.24; 95% CI, 1.07 to 1.45; p < .01). Advanced age (p < .0001), hypertension (p = .0139), head injury (p = .0003), and stroke (p = .041) were found to be risk factors for dementia, while patients with high socioeconomic status (p < .01) and history of coronary artery disease (p = .0292) were unlikely to develop dementia in our cohort study.ConclusionPatients with hernias were associated with a higher incidence of dementia than those without. Our finding should be validated in further prospective studies with larger samples.

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Section: Discussionmentioning

confidence: 99%

“…The major strength of the current investigation was the utilization of a nationwide population-based database as well as the longi- (Ashrafi, Siddaiah-Subramanya, Memon, & Memon, 2019).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association between abdominal hernia and the risk of subsequent dementia

et al. 2019

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“…Recurrences after inguinal hernia repairs can occur even up to 50 years later [2]. In recent administrative data and registry analyses it was revealed that the proportion of recurrent repairs in the total collective of inguinal hernia repairs among men was 11.3-14.3% [3][4][5][6][7] and in women 7.0-7.4% [4,8]. By contrast, in systematic reviews and meta-analyses the recurrence rates were still far lower (1.2-3%) than those cited above since the included studies had a maximum follow-up time of 6 years [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

What is the outcome of re-recurrent vs recurrent inguinal hernia repairs? An analysis of 16,206 patients from the Herniamed Registry

Köckerling

Krüger

Gagarkin³

et al. 2020

Hernia

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Introduction The proportion of recurrent repairs in the total collective of inguinal hernia repairs among men is 11.3-14.3% and among women 7.0-7.4%. The rate of re-recurrences is reported to be 2.9-9.2%. To date, no case series has been published on second and ≥ third recurrences and their treatment outcomes. Only case reports are available. Materials and methods In an analysis of data from the Herniamed Registry the perioperative and 1-year follow-up outcomes of 16,206 distinct patients who had undergone first recurrent (n = 14,172; 87.4%), second recurrent (n = 1,583; 9.8%) or ≥ third recurrent (n = 451; 2.8%) inguinal hernia repair between September 1, 2009 and July 1, 2017 were compared. Results The intraoperative complication rate for all recurrent repairs was between 1-2%. In the postoperative complications a continuous increase was observed (first recurrence: 3.97% vs second recurrence: 5.75% vs ≥ third recurrence 8.65%; p < 0.001). That applied equally to the complication-related reoperation rates (first recurrence: 1.50% vs second recurrence: 2.21% vs ≥ third recurrence 2.66; p = 0.020). Likewise, the re-recurrence rate rose significantly (first recurrence: 1.95% vs second recurrence: 2.72% vs ≥ third recurrence 3.77; p = 0.005). Similarly, the rate of pain requiring treatment rose highly significantly with an increasing number of recurrences (first recurrence: 5.21% vs second recurrence: 6.70% vs ≥ third recurrence 10.86; p = < 0.001). Conclusion The repair of re-recurrences in inguinal hernia is associated with increasingly more unfavorable outcomes. For the first recurrence the guidelines should definitely be noted. For a second and ≥ third recurrence diagnostic laparoscopy may help to select the best possible surgical technique.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…Besides a weakened abdominal wall after radical resection, other factors including genetic aspects and increased abdominal pressure can lead to pelvic incarceration through the surgically produced hernia gap . In our case, the patient's overweight was the most important risk factor known to increase the recurrence rate . In these patients, prophylactic mesh reinforcement may avoid such complications.…”

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confidence: 66%