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Inguinal hernia repairs performed for recurrence in Spain: population-based study of 16 years and 1,302,788 patients

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Abstract

Purpose

The objective of this study was to assess data on inguinal hernia repairs (IHR) performed for recurrence over a 16 year period (2004—2019) in Spain.

Methods

A retrospective cohort study of 1,302,788 patients who underwent IHR from January 2004 to December 2019 was conducted. Data were extracted from the Spanish Minimum Basic Data Set (MBDS) of the Health Ministry database. The primary objective was to analyse the proportion of IHR performed by recurrence. As secondary objectives, we evaluated factors related to recurrent hernia (analysed by univariate analysis and multivariable logistic regression analysis) and trends in the recurrent case rate over the 16 year period.

Results

We identified 95,025 patients (7.3% of all IHR) who underwent surgery for recurrent inguinal hernia. Patients undergoing recurrent IHR were more likely to be male (OR 1.687, 95% CI 1.645–1.730), elderly (age > 74 years), and more complicated when they arrived in the operating room (gangrene OR 3.951, 95% CI 3.734–4.180; occlusion OR 1.905, 95% CI 1.853–1.960), and thus had more surgical site occurrences and related mortality. The proportion of IHR performed for recurrence has been dropping over the years (8.7% in 2004 vs. 6.5% in 2019, p < 0.005).

Conclusion

The rate of recurrent IHR in Spain (2004–2019) is 7.3%. Recurrent IHR correlates to emergent and complicated surgery and thus to a worst outcome. The trend of this 16 year period is of decreasing operated recurrent inguinal hernia. This is good news even though the improvement is slight and certainly insufficient. Establishing and optimising the rate of hernia recurrence is important for patients and for the health-care system.

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Acknowledgements

The authors thank the Spanish Ministry of Health, Social Services and Equality of Spain for permission to obtain the data.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Hospital Clinic de Barcelona, Clinic-Plató. C/Plató 21, 08006, Barcelona, Spain

    S. Guillaumes

  2. Department of Surgery, Hospital Universitari de Granollers, Universitat Internacional de Catalunya, Granollers, Spain

    M. Juvany

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  1. S. Guillaumes
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Correspondence to S. Guillaumes.

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The authors state that they have no conflict of interest.

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Because only anonymised public data, requested from the Ministry of Health, Social Services and Equality of Spain, was analysed, ethical approval was not necessary.

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This article does not include any studies with animals performed by any of the authors.

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Because only anonymised routine data was analysed, informed consent of the patients is not required.

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Guillaumes, S., Juvany, M. Inguinal hernia repairs performed for recurrence in Spain: population-based study of 16 years and 1,302,788 patients. Hernia 26, 1023–1032 (2022). https://doi.org/10.1007/s10029-022-02630-w

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