Skip to main content
SpringerLink
Log in

Proportion of femoral hernia repairs performed for recurrence in the United States

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

Recurrence rates after femoral hernia repair (FHR) have not been reliably established in the USA. We sought to determine this trend over time.

Methods

The proportion of primary and recurrent FHRs was determined for patients age ≥ 18 from: ACS-NSQIP (1/2005–12/2014), Premier (1/2010–09/2015), and institutional (1/2005–12/2014) data. Trends were analyzed using a one-tailed Cochran–Armitage test.

Results

In the NSQIP database, 6649 patients underwent a FHR. In females, the proportion of FHRs performed for recurrence decreased from 14.0% in 2005 to 6.2% in 2014, p = 0.02. In males, there was no change: 16.7–16.1% 2005–2014 (p = 0.18). The Premier database included 4495 FHRs and our institution 315 FHRs. There was no difference for either gender over time in either data source, all p > 0.05.

Conclusions

The proportion of femoral hernia repairs performed for recurrence in the USA remained relatively constant in males in two large national databases between 2005 and 2015. In females, a decrease was seen in one of the large national databases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P et al (2001) Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet (London England) 358:1124–1128

    Article  CAS  Google Scholar 

  2. Glassow F (1985) Femoral hernia. Review of 2105 repairs in a 17 year period. Am J Surg 150:353–356

    Article  PubMed  CAS  Google Scholar 

  3. Hernandez-Richter T, Schardey HM, Rau HG, Schildberg FW, Meyer G (2000) The femoral hernia: an ideal approach for the transabdominal preperitoneal technique (TAPP). Surg Endosc 14:736–740

    Article  PubMed  CAS  Google Scholar 

  4. Sandblom G, Gruber G, Kald A, Nilsson E (2000) Audit and recurrence rates after hernia surgery. Eur J Surg Acta Chirurgica 166:154–158

    Article  PubMed  CAS  Google Scholar 

  5. Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83:1045–1051 (v–vi)

    Article  PubMed  Google Scholar 

  6. Beadles CA, Meagher AD, Charles AG (2015) Trends in emergent hernia repair in the United States. JAMA Surg 150:194–200

    Article  PubMed  Google Scholar 

  7. Dahlstrand U, Wollert S, Nordin P, Sandblom G, Gunnarsson U (2009) Emergency femoral hernia repair: a study based on a national register. Ann Surg 249:672–676

    Article  PubMed  Google Scholar 

  8. Humes DJ, Radcliffe RS, Camm C, West J (2013) Population-based study of presentation and adverse outcomes after femoral hernia surgery. Br J Surg 100:1827–1832

    Article  PubMed  CAS  Google Scholar 

  9. Murphy BL, Ubl DS, Zhang J, Habermann EB, Farley DR, Paley K (2017) Trends of inguinal hernia repairs performed for recurrence in the United States. Surgery 163(2):343–350

    Article  PubMed  Google Scholar 

  10. Andresen K, Bisgaard T, Kehlet H, Wara P, Rosenberg J (2014) Reoperation rates for laparoscopic vs open repair of femoral hernias in Denmark: a nationwide analysis. JAMA Surgery 149:853–857

    Article  PubMed  Google Scholar 

  11. Alimoglu O, Kaya B, Okan I, Dasiran F, Guzey D, Bas G et al (2006) Femoral hernia: a review of 83 cases. Hernia J Hernias Abdom Wall Surg 10:70–73

    Article  CAS  Google Scholar 

  12. Pangeni A, Shakya VC, Shrestha AR, Pandit R, Byanjankar B, Rai S (2017) Femoral hernia: reappraisal of low repair with the conical mesh plug. Hernia J Hernias Abdom Wall Surg 21:73–77

    Article  CAS  Google Scholar 

  13. Cox TC, Huntington CR, Blair LJ, Prasad T, Heniford BT, Augenstein VA (2016) Quality of life and outcomes for femoral hernia repair: does laparoscopy have an advantage. Hernia J Hernias Abdom Wall Surg 21:79–88

    Article  Google Scholar 

  14. Cox TC, Huntington CR, Blair LJ, Prasad T, Heniford BT, Augenstein VA (2017) Quality of life and outcomes for femoral hernia repair: does laparoscopy have an advantage? Hernia J Hernias Abdom Wall Surg 21:79–88

    Article  CAS  Google Scholar 

  15. Bendavid R (1989) Femoral hernias: primary versus recurrence. Int Surg 74:99–100

    PubMed  CAS  Google Scholar 

  16. Thill RH, Hopkins WM (1994) The use of Mersilene mesh in adult inguinal and femoral hernia repairs: a comparison with classic techniques. Am Surg 60:553–556 (discussion 6–7)

    PubMed  CAS  Google Scholar 

  17. Waltz P, Luciano J, Peitzman A, Zuckerbraun BS (2016) Femoral hernias in patients undergoing total extraperitoneal laparoscopic hernia repair: including routine evaluation of the femoral canal in approaches to inguinal hernia repair. JAMA Surg 151:292–293

    Article  PubMed  Google Scholar 

  18. Kald A, Nilsson E, Anderberg B, Bragmark M, Engstrom P, Gunnarsson U et al (1998) Reoperation as surrogate endpoint in hernia surgery. A three year follow-up of 1565 herniorrhaphies. Eur J Surg Acta Chirurgica 164:45–50

    Article  PubMed  CAS  Google Scholar 

  19. Song Y, Lu A, Ma D, Wang Y, Wu X, Lei W (2015) Long-term results of femoral hernia repair with ULTRAPRO plug. J Surg Res 194:383–387

    Article  PubMed  Google Scholar 

  20. Henriksen NA, Thorup J, Jorgensen LN (2012) Unsuspected femoral hernia in patients with a preoperative diagnosis of recurrent inguinal hernia. Hernia J Hernias Abdom Wall Surg 16:381–385

    Article  CAS  Google Scholar 

  21. Rosemar A, Angeras U, Rosengren A, Nordin P (2010) Effect of body mass index on groin hernia surgery. Ann Surg 252:397–401

    Article  PubMed  Google Scholar 

  22. Sucandy I, Kolff JW (2012) Incarcerated femoral hernia in men: incidence, diagnosis, and surgical management. North Am J Med Sci 4:617–618

    Article  Google Scholar 

  23. Malek S, Torella F, Edwards PR (2004) Emergency repair of groin herniae: outcome and implications for elective surgery waiting times. Int J Clin Pract 58:207–209

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge and thank the Mayo Clinic Department of Surgery, the Kern Center for the Science of Health Care Delivery, and Medtronic as substantial contributors of resources to this project.

Funding

The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery provides salary support for Dr. Habermann, Dr. Murphy, and Mr. Ubl. Dr. Jianying Zhang is an employee of Medtronic and provided the analysis of the Premier Database. No external funding was used. This work was presented as an e-poster presentation at the Southwest Surgical Congress Annual Meeting in Maui, Hawaii April 2017.

Author information

Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA

    B. L. Murphy, D. Farley & K. Paley

  2. The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA

    B. L. Murphy, D. S. Ubl & E. B. Habermann

  3. Minimally Invasive Therapies Group, Medtronic, Mansfield, MA, USA

    J. Zhang

Authors
  1. B. L. Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. S. Ubl
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. B. Habermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Farley
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. Paley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K. Paley.

Ethics declarations

Conflicts of interest

BM declares no conflict of interest DU declares no conflict of interest. JZ declares no conflict of interest. EH declares no conflict of interest. DF declares no conflict of interest. KP declares no conflict of interest.

Disclosures

The authors have no conflicts of interest to disclose. Dr. Zhang is an employee of Medtronic and completed the analysis of the Premier database. We teamed with Medtronic to help perform the statistical analyses of the Premier database due to their expertise in analyzing this extensive data source. Medtronic shared in our goals of identifying the current state of hernia repairs in the United States as a whole and offered to partner with us for this study. Dr. Zhang performed the statistical analysis of the Premier data, which was critically evaluated and discussed among all authors. All authors were involved in data interpretation. Our agreement with Medtronic precluded financial considerations for this project.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights

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

Informed consent

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Murphy, B.L., Ubl, D.S., Zhang, J. et al. Proportion of femoral hernia repairs performed for recurrence in the United States. Hernia 22, 593–602 (2018). https://doi.org/10.1007/s10029-018-1743-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-018-1743-y

Keywords

Search

Navigation