Congenital collagenopathies increased the risk of inguinal hernia developing and repair: analysis from a nationwide population-based cohort study

Abstract

Herein, we aimed to explore whether male patients with congenital collagen diseases had a higher risk of inguinal herniation than patients without these diseases. Data were retrospectively collected from the National Health Insurance Research Database of Taiwan. The study cohort included 1,801 male patients diagnosed with congenital collagen diseases based on the ICD-9 CM diagnostic codes; after propensity score matching, the control group comprised 6,493 men without congenital collagen diseases. The primary endpoint was inguinal hernia repair during the observation period. During a median follow-up period of 133.9 months, the risk of inguinal herniation in the collagen group was significantly higher than that in the control group (HR = 2.237, 95% CI 1.646–3.291, p < 0.001). This phenomenon was observed in patients younger than 18 years (HR: 3.040, 95% CI 1.819–5.083, p < 0.001) and in those aged 18–80 years (HR: 1.909, 95% CI 1.186–3.073, p < 0.001). Asian men with congenital collagen diseases are at a high risk of developing inguinal hernias, regardless of age. Detailed physical examination and patient education should be performed for these patients to prevent inguinal herniation.

A Comprehensive Review of Inguinal Hernia Occurrence in Obese Individuals

“…Some studies suggested that inguinal hernias are not just the result of a primary defect, but they could also arise as the consequence of a systemic disease regarding collagen distribution (35). This hypothesis could be also suggested if we take into account the genetic aspects of inguinal hernia disease (36), as well as the higher recurrence of inguinal hernia amongst patients diagnosed with congenital collagenopathy (37). This is why, in the following part, we will discuss some particularities of the extracellular matrix in inguinal hernia patients, as well as in obese patients.…”

Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

“…In performing the literature review, it was found one systematic review and meta-analysis [ 22 ], one systematic review [ 23 ], two narrative reviews [ 24 , 25 ], one clinical trial [ 26 ], eight observational studies [ [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ], and one case series [ 35 ], that discussed the relationship between some risk factors, interventions and outcomes in the management of inguinal hernia.…”

“…It is presumed then, that the higher the pain score and neuronal involvement, the slower and more difficult will be the long-term post-operative pain recovery process. Recently, Chang et al [ 27 ] published an interesting study, where they studied 1801 men with a congenital collagenopathy vs. a control group (6493 men), showing that the risk of developing inguinal hernia was significantly higher in the group with the pathological history (HR 2.237; 95% CI, 1.646–3.291, p < 0.001), compared to the control group [ 27 ]. This risk is much higher in those under 18 years of age (HR 3.040; 95% CI, 1.819–5.083, p < 0.001), compared to any other age group.…”

“…This risk is much higher in those under 18 years of age (HR 3.040; 95% CI, 1.819–5.083, p < 0.001), compared to any other age group. The authors concluded that this was an at-risk population that should be followed closely [ 27 ], because there are no recommendations for preventive interventions at present.…”

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Fig. 1 Summary of pre-operative and surgical factors predicting overall outcome in inguinal hernia repair [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ]. Created with BioRender.

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