Groin hernia subtypes are associated in patients with bilateral hernias: a 14-year nationwide epidemiologic study

Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans‐Christian; Rosenberg, Jacob

doi:10.1007/s00464-014-3905-z

Cited by 6 publications

(5 citation statements)

References 35 publications

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“…5893 of these patients were females who were followed up for up to 6 years and found to have a higher recurrence rate after indirect inguinal herniorrhaphies. But this finding has not been observed when evaluating recurrence after laparoscopic inguinal herniorrhaphy [16]. This may be because during the laparoscopic inguinal hernia repair, the presence of femoral hernia (or for that matter any other groin hernia) is far easily detectable during a methodical dissection and exploration of the preperitoneal or extraperitoneal space with high resolution and magnified imaging technology routinely deployed for laparoscopic procedures.…”

Section: Gendermentioning

confidence: 99%

Causes of recurrence in laparoscopic inguinal hernia repair

Siddaiah‐Subramanya

Ashrafi

Memon

et al. 2018

Hernia

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Recurrence can occur at any stage following inguinal hernia surgery. Patients' risk factors such as higher BMI, smoking, diabetes and postoperative surgical site infections increase the risk of recurrence and can be modified. Amongst the surgical factors, surgeon's experience, larger mesh with better tissue overlap and careful surgical techniques to reduce the incidence of seroma or hematoma help reduce the recurrence rate. Other factors including type of mesh and fixation of mesh have not shown any difference in the incidence of recurrence. It is hoped that future randomized controlled trials will address some of these issues and initiate preoperative management strategies to modify some of these risk factors to lower the risk of recurrence following laparoscopic inguinal herniorrhaphy.

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Section: Gendermentioning

confidence: 99%

Causes of recurrence in laparoscopic inguinal hernia repair

Siddaiah‐Subramanya

Ashrafi

Memon

et al. 2018

Hernia

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“…Risk factors associated with IH formation (evidence level—moderate): Primary hernia type (both indirect and direct subtypes are bilaterally associated). 39 Increased systemic levels of matrix metalloproteinase-2. 40 – 43 Rare connective tissue disorders (e.g.…”

Section: Risk Factors For the Development Of Inguinal Hernias In Adulmentioning

confidence: 99%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,554

712

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IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

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“…Incarceration and strangulation are the most common serious complications of femoral hernias and relatively higher than in inguinal ones, therefore repair of asymptomatic incidentally found femoral hernia is also recommended. If bilateral femoral hernia is present, both sides should be addressed [3] , [7] .…”

Section: Discussionmentioning

confidence: 99%

“…Elective and emergent femoral hernia repairs constitute roughly 2–4 % of all groin hernia repairs and occur approximately 4 times more commonly in women, especially over the age of 50 (Little Old Ladies Hernia). Bilateral hernias are common and often the same subtype of hernia [3] . Clinical signs of femoral hernia are not always obvious and up to 40 % are overseen in open repair techniques [2] , [4] .…”

Section: Introductionmentioning

confidence: 99%