Igor Wanko Mboumi, MD, Yiwei Xu, MHS, Jacob Greenberg, MD, Luke Funk, MD, Amber Shada, MD, Anne Lidor, MD. University of Wisconsin
Background: Inguinal hernia repair is one of the most frequently performed procedures in the United States. The optimal surgical approach, whether laparoscopic or open, remains a subject of debate. While certain clinical scenarios may favor laparoscopic herniorrhaphy, such as bilateral or recurrent cases, the majority of inguinal hernia repairs in this country are performed open. This study endeavoured to determine the rate of subsequent hernia surgery after initial inguinal hernia repair and to identify risk factors that predict the need for reoperation.
Methods: Data from the Truven Health MarketScan® Research Databases were analyzed. Adult patients with a CPT procedure code for outpatient inguinal hernia repair from 2012-2014 were included. Only patients with continuous enrollment for 6 months prior to, and following, surgery were included. Performance of another inguinal hernia repair within at least 6 months of the initial surgery was captured using the same procedure codes. Multivariable logistic regression was used to identify risk factors for reoperation.
Results: 88,331 cases were identified (91.4% male), with mean age of 55. Most patients underwent open herniorrhaphy, and men underwent laparoscopic and bilateral repair more frequently than women (32.1% vs. 27.2% and 13.4% vs. 7.1%). The overall rate of reoperation for both men and women was similar (8.3% vs. 7.9%, respectively). On adjusted analysis, surgery for recurrent inguinal hernia resulted in significantly increased odds for another hernia repair (1.16, CI=1.06,1.26), and patients who underwent bilateral repair had a significantly lower odds of reoperation (OR=0.48, CI=0.44,0.53).
Conclusion: The rate of subsequent hernia repair after inguinal herniorraphy is significant. Most notable is the nearly 50% reduction in the odds of subsequent inguinal herniorrhaphy in patients who undergo bilateral inguinal hernia repair initially. This may reflect an advantage of laparoscopy in affording a means to identify and treat a subclinical hernia on the contralateral side.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95485
Program Number: P574
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster