Is a Technically Challenging Procedure More Likely to Fail? A Prospective Single-Center Study on the Short- and Long-Term Outcomes of Inguinal Hernia Repair

الملخص EN

Background and Aims.

The aim of this prospective single-center study was to evaluate the outcome of inguinal hernia repair.

Materials and Methods.

A total of 485 inguinal hernias (452 patients and 33 patients with bilateral hernias) were operated between January 2004 and December 2010.

Mean age was 56 years, and 93% were male.

Patient demographics and operative data were collected, and the operating surgeon assessed the technical difficulty of the operation.

Five years after surgery, a questionnaire evaluated recurrence and chronic discomfort according to the Cunningham scale.

372 responded (82%), and mean follow-up was 5.5 years.

Results.

There were 390 repairs for a primary and 62 for a recurrent hernia.

Totally extraperitoneal (TEP) operation was most frequently performed (56%), transabdominal preperitoneal (TAPP) operation in 31%, and Lichtenstein and Shouldice in 12% and 2%, respectively.

At 5-year follow-up, the primary outcome of chronic discomfort was 19.5%.

The independent positive predictors were young age and operation for a recurrent hernia (OR: 3.7), with TEP operation reducing the risk of chronic discomfort (OR: 0.5).

The secondary outcome was the recurrence rate of 2.5%.

Risk factors were strenuous work (OR: 13.7), technically difficult repairs (OR: 7.2), and chronic discomfort (OR: 6.7).

Conclusions.

Every fifth patient had chronic discomfort in long-term follow-up.

The recurrence rate was 2.5%, and a technically difficult procedure was a risk factor.