Skip to main content
Top
Published in: Hernia 4/2006

01-08-2006 | Original Article

Risk factors related to recurrence in inguinal hernia repair: a retrospective analysis

Authors: K. Junge, R. Rosch, U. Klinge, R. Schwab, Ch. Peiper, M. Binnebösel, F. Schenten, V. Schumpelick

Published in: Hernia | Issue 4/2006

Login to get access

Abstract

The aim of this study was to analyze and evaluate the long-term recurrence rate and risk factors for inguinal hernia recurrence in patients treated by the Shouldice suture repair. A total of 293 hernias treated by Shouldice suture technique in 1992 were studied retrospectively. After a 10-year follow-up, 15 potential risk factors for recurrence were assessed in 142 patients undergoing 171 Shouldice repairs. Recurrent hernias showed a significantly higher (22.0%) recurrence rate than primary inguinal hernias (7.7%). Furthermore, an age of more than 50 years, smoking, and the presence of two or more similarly affected relatives were found to be independent risk factors for recurrence. The present study underlines the importance of patient-related risk factors for the development of a recurrent inguinal hernia. Patients at risk should preoperatively be identified in order to improve treatment by, for example, the application of mesh techniques.
Literature
1.
go back to reference Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMed Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMed
2.
go back to reference Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398CrossRefPubMed Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398CrossRefPubMed
3.
go back to reference Glassow F (1986) The Shouldice hospital technique. Int Surg 71:148–153PubMed Glassow F (1986) The Shouldice hospital technique. Int Surg 71:148–153PubMed
4.
5.
go back to reference Anonymous (2000) The Danish hernia database – the first year. Ugeskr Laeger 162:1552–1555 Anonymous (2000) The Danish hernia database – the first year. Ugeskr Laeger 162:1552–1555
6.
go back to reference Robbins AW, Rutkow IM (1998) Mesh plug repair and groin hernia surgery. Surg Clin North Am 78:1007–1011CrossRefPubMed Robbins AW, Rutkow IM (1998) Mesh plug repair and groin hernia surgery. Surg Clin North Am 78:1007–1011CrossRefPubMed
7.
go back to reference Amid PK, Shulman AG, Lichtenstein IL (1996) Open “tension-free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162:447–453PubMed Amid PK, Shulman AG, Lichtenstein IL (1996) Open “tension-free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162:447–453PubMed
8.
go back to reference Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518CrossRefPubMed Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518CrossRefPubMed
9.
10.
go back to reference Beets GL, van Geldere D, Baeten CG, Go PM (1996) Long-term results of giant prosthetic reinforcement of the visceral sac for complex recurrent inguinal hernia [see comments]. Br J Surg 83:203–206CrossRefPubMed Beets GL, van Geldere D, Baeten CG, Go PM (1996) Long-term results of giant prosthetic reinforcement of the visceral sac for complex recurrent inguinal hernia [see comments]. Br J Surg 83:203–206CrossRefPubMed
11.
go back to reference Ott V, Groebli Y, Schneider R (2005) Late intestinal fistula formation after incisional hernia using intraperitoneal mesh. Hernia 9:103–104CrossRefPubMed Ott V, Groebli Y, Schneider R (2005) Late intestinal fistula formation after incisional hernia using intraperitoneal mesh. Hernia 9:103–104CrossRefPubMed
12.
go back to reference Benedetti M, Albertario S, Niebel T, Bianchi C, Tinozzi FP, Moglia P, Arcidiaco M, Tinozzi S (2005) Intestinal perforation as a long-term complication of plug and mesh inguinal hernioplasty: case report. Hernia 9:93–95CrossRefPubMed Benedetti M, Albertario S, Niebel T, Bianchi C, Tinozzi FP, Moglia P, Arcidiaco M, Tinozzi S (2005) Intestinal perforation as a long-term complication of plug and mesh inguinal hernioplasty: case report. Hernia 9:93–95CrossRefPubMed
13.
go back to reference Nowak DD, Chin AC, Singer MA, Helton WS (2005) Large scrotal hernia: a complicated case of mesh migration, ascites, and bowel strangulation. Hernia 9:96–99CrossRefPubMed Nowak DD, Chin AC, Singer MA, Helton WS (2005) Large scrotal hernia: a complicated case of mesh migration, ascites, and bowel strangulation. Hernia 9:96–99CrossRefPubMed
14.
go back to reference Amid PK (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia 7:13–16CrossRefPubMed Amid PK (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia 7:13–16CrossRefPubMed
15.
go back to reference Rosch R, Junge K, Lynen P, Mertens PR, Klinge U, Schumpelick V (2003) Hernia - a collagen disease? Eur Surg 35:11–15CrossRef Rosch R, Junge K, Lynen P, Mertens PR, Klinge U, Schumpelick V (2003) Hernia - a collagen disease? Eur Surg 35:11–15CrossRef
16.
go back to reference Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B, Lynen P, Schumpelick V (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389:17–22CrossRefPubMed Junge K, Klinge U, Rosch R, Mertens PR, Kirch J, Klosterhalfen B, Lynen P, Schumpelick V (2004) Decreased collagen type I/III ratio in patients with recurring hernia after implantation of alloplastic prostheses. Langenbecks Arch Surg 389:17–22CrossRefPubMed
17.
go back to reference Klinge U, Krones CJ (2005) Can we be sure that the meshes do improve the recurrence rates? Hernia 9:1–2CrossRefPubMed Klinge U, Krones CJ (2005) Can we be sure that the meshes do improve the recurrence rates? Hernia 9:1–2CrossRefPubMed
18.
go back to reference Arlt G, Schumpelick V (2002) The Shouldice repair for inguinal hernia – technique and results. Zentralbl Chir 127:565–569CrossRefPubMed Arlt G, Schumpelick V (2002) The Shouldice repair for inguinal hernia – technique and results. Zentralbl Chir 127:565–569CrossRefPubMed
19.
go back to reference Schjoth-Iversen L, Nilsen B, Line PD (1996) The recurrence frequency in inguinal hernia. A 10-year survival material. Tidsskr Nor Laegeforen 116:2774–2775PubMed Schjoth-Iversen L, Nilsen B, Line PD (1996) The recurrence frequency in inguinal hernia. A 10-year survival material. Tidsskr Nor Laegeforen 116:2774–2775PubMed
20.
go back to reference Arvidsson D, Berndsen FH, Larsson LG, Leijonmarck CE, Rimback G, Rudberg C, Smedberg S, Spangen L, Montgomery A (2005) Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia. Br J Surg 92:1085–1091CrossRefPubMed Arvidsson D, Berndsen FH, Larsson LG, Leijonmarck CE, Rimback G, Rudberg C, Smedberg S, Spangen L, Montgomery A (2005) Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia. Br J Surg 92:1085–1091CrossRefPubMed
21.
go back to reference Herzog U (1990) Recurrent inguinal hernia. Schweiz Rundsch Med Prax 79:1166–1169PubMed Herzog U (1990) Recurrent inguinal hernia. Schweiz Rundsch Med Prax 79:1166–1169PubMed
22.
go back to reference Nilsson E, Kald A, Anderberg B, Bragmark M, Fordell R, Haapaniemi S, Heuman R, Lindhagen J, Stubberod A, Wickbom J (1997) Hernia surgery in a defined population: a prospective three year audit. Eur J Surg 163:823–829PubMed Nilsson E, Kald A, Anderberg B, Bragmark M, Fordell R, Haapaniemi S, Heuman R, Lindhagen J, Stubberod A, Wickbom J (1997) Hernia surgery in a defined population: a prospective three year audit. Eur J Surg 163:823–829PubMed
23.
go back to reference Schaap HM, van de Pavoordt HD, Bast TJ (1992) The preperitoneal approach in the repair of recurrent inguinal hernias. Surg Gynecol Obstet 174:460–464PubMed Schaap HM, van de Pavoordt HD, Bast TJ (1992) The preperitoneal approach in the repair of recurrent inguinal hernias. Surg Gynecol Obstet 174:460–464PubMed
24.
go back to reference Sorensen LT, Friis E, Jorgensen T, Vennits B, Andersen BR, Rasmussen GI, Kjaergaard J (2002) Smoking is a risk factor for recurrence of groin hernia. World J Surg 26:397–400CrossRefPubMed Sorensen LT, Friis E, Jorgensen T, Vennits B, Andersen BR, Rasmussen GI, Kjaergaard J (2002) Smoking is a risk factor for recurrence of groin hernia. World J Surg 26:397–400CrossRefPubMed
25.
go back to reference Aggarwal BB, Totpal K, LaPushin R, Chaturvedi MM, Pereira-Smith OM, Smith JR (1995) Diminished responsiveness of senescent normal human fibroblasts to TNF-dependent proliferation and interleukin production is not due to its effect on the receptors or on the activation of a nuclear factor NF-kappa B. Exp Cell Res 218:381–388CrossRefPubMed Aggarwal BB, Totpal K, LaPushin R, Chaturvedi MM, Pereira-Smith OM, Smith JR (1995) Diminished responsiveness of senescent normal human fibroblasts to TNF-dependent proliferation and interleukin production is not due to its effect on the receptors or on the activation of a nuclear factor NF-kappa B. Exp Cell Res 218:381–388CrossRefPubMed
26.
go back to reference Ashcroft GS, Horan MA, Ferguson MW (1997) Aging is associated with reduced deposition of specific extracellular matrix components, an upregulation of angiogenesis, and an altered inflammatory response in a murine incisional wound healing model. Int J Biochem Cell Biol 29:211–220CrossRefPubMed Ashcroft GS, Horan MA, Ferguson MW (1997) Aging is associated with reduced deposition of specific extracellular matrix components, an upregulation of angiogenesis, and an altered inflammatory response in a murine incisional wound healing model. Int J Biochem Cell Biol 29:211–220CrossRefPubMed
27.
go back to reference Ashcroft GS, Horan MA, Ferguson MW (1997) The effects of ageing on wound healing: immunolocalisation of growth factors and their receptors in a murine incisional model. J Surg Res 70:1–6CrossRefPubMed Ashcroft GS, Horan MA, Ferguson MW (1997) The effects of ageing on wound healing: immunolocalisation of growth factors and their receptors in a murine incisional model. J Surg Res 70:1–6CrossRefPubMed
28.
go back to reference Meyer LJ, Stern R (1994) Age-dependent changes of hyaluronan in human skin. J Invest Dermatol 102:385–389CrossRefPubMed Meyer LJ, Stern R (1994) Age-dependent changes of hyaluronan in human skin. J Invest Dermatol 102:385–389CrossRefPubMed
29.
go back to reference Akin ML, Karakaya M, Batkin A, Nogay A (1997) Prevalence of inguinal hernia in otherwise healthy males of 20 to 22 years of age. J R Army Med Corps 143:101–102PubMed Akin ML, Karakaya M, Batkin A, Nogay A (1997) Prevalence of inguinal hernia in otherwise healthy males of 20 to 22 years of age. J R Army Med Corps 143:101–102PubMed
30.
go back to reference Girotto JA, Malaisrie SC, Bulkely G, Manson PN (2000) Recurrent ventral herniation in Ehlers-Danlos syndrome. Plast Reconstr Surg 106:1520–1526CrossRefPubMed Girotto JA, Malaisrie SC, Bulkely G, Manson PN (2000) Recurrent ventral herniation in Ehlers-Danlos syndrome. Plast Reconstr Surg 106:1520–1526CrossRefPubMed
31.
go back to reference Liapis CD, Dimitroulis DA, Kakisis JD, Nikolaou AN, Skandalakis P, Daskalopoulos M, Kostakis AG (2004) Incidence of incisional hernias in patients operated on for aneurysm or occlusive disease. Am Surg 70:550–552PubMed Liapis CD, Dimitroulis DA, Kakisis JD, Nikolaou AN, Skandalakis P, Daskalopoulos M, Kostakis AG (2004) Incidence of incisional hernias in patients operated on for aneurysm or occlusive disease. Am Surg 70:550–552PubMed
32.
go back to reference Raffetto JD, Cheung Y, Fisher JB, Cantelmo NL, Watkins MT, Lamorte WW, Menzoian JO (2003) Incision and abdominal wall hernias in patients with aneurysm or occlusive aortic disease. J Vasc Surg 37:1150–1154CrossRefPubMed Raffetto JD, Cheung Y, Fisher JB, Cantelmo NL, Watkins MT, Lamorte WW, Menzoian JO (2003) Incision and abdominal wall hernias in patients with aneurysm or occlusive aortic disease. J Vasc Surg 37:1150–1154CrossRefPubMed
33.
go back to reference Jorgensen LN, Kallehave F, Christensen E, Siana JE, Gottrup F (1998) Less collagen production in smokers. Surgery 123:450–455PubMed Jorgensen LN, Kallehave F, Christensen E, Siana JE, Gottrup F (1998) Less collagen production in smokers. Surgery 123:450–455PubMed
34.
go back to reference Jensen JA, Goodson WH, Hopf HW, Hunt TK (1991) Cigarette smoking decreases tissue oxygen. Arch Surg 126:1131–1134PubMed Jensen JA, Goodson WH, Hopf HW, Hunt TK (1991) Cigarette smoking decreases tissue oxygen. Arch Surg 126:1131–1134PubMed
35.
go back to reference Jonsson K, Jensen JA, Goodson WH III, Scheuenstuhl H, West J, Hopf HW, Hunt TK (1991) Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surg 214:605–613PubMedCrossRef Jonsson K, Jensen JA, Goodson WH III, Scheuenstuhl H, West J, Hopf HW, Hunt TK (1991) Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surg 214:605–613PubMedCrossRef
36.
go back to reference Cannon DJ, Read RC (1981) Metastatic emphysema: a mechanism for acquiring inguinal herniation. Ann Surg 194:270–278PubMedCrossRef Cannon DJ, Read RC (1981) Metastatic emphysema: a mechanism for acquiring inguinal herniation. Ann Surg 194:270–278PubMedCrossRef
37.
go back to reference Haapaniemi S, Gunnarsson U, Nordin P, Nilsson E (2001) Reoperation after recurrent groin hernia repair. Ann Surg 234:122–126CrossRefPubMed Haapaniemi S, Gunnarsson U, Nordin P, Nilsson E (2001) Reoperation after recurrent groin hernia repair. Ann Surg 234:122–126CrossRefPubMed
38.
go back to reference Nilsson E, Haapaniemi S, Gruber G, Sandblom G (1998) Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996. Br J Surg 85:1686–1691CrossRefPubMed Nilsson E, Haapaniemi S, Gruber G, Sandblom G (1998) Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996. Br J Surg 85:1686–1691CrossRefPubMed
39.
Metadata
Title
Risk factors related to recurrence in inguinal hernia repair: a retrospective analysis
Authors
K. Junge
R. Rosch
U. Klinge
R. Schwab
Ch. Peiper
M. Binnebösel
F. Schenten
V. Schumpelick
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
Hernia / Issue 4/2006
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-006-0096-0

Other articles of this Issue 4/2006

Hernia 4/2006 Go to the issue