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Published in: Hernia 3/2020

Open Access 01-06-2020 | Incisional Hernia | Original Article

Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Authors: F. Köckerling, H. Hoffmann, D. Adolf, D.Weyhe, W. Reinpold, A. Koch, P. Kirchhoff

Published in: Hernia | Issue 3/2020

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Abstract

Introduction

To date, little attention has been paid by surgical scientific studies to sex as a potential influence factor on the outcome. Therefore, there is a sex bias in the surgical literature. With an incidence of more than 20% after 3 years, incisional hernias are a common complication following abdominal surgical procedures. The proportion of women affected is around 50%. There are very few references in the literature to the influence of sex on the outcome of elective incisional hernia repair.

Materials and methods

In all, 22,895 patients with elective incisional hernia repair from the Herniamed Registry were included in the study. The patients had undergone elective incisional hernia repair in a laparoscopic IPOM, open sublay, open IPOM, open onlay or suture technique. 1-year follow-up was available for all patients. Propensity score matching was performed for the 11,480 female (50.1%) and 11,415 male (49.9%) patients, creating 8138 pairs (82.0%) within fixed surgical procedures.

Results

For pain on exertion (11.7% vs 18.3%; p < 0.001), pain at rest (7.53% vs 11.1%; p < 0.001), and pain requiring treatment (5.4% vs 9.1%; p < 0.001) highly significant disadvantages were identified for the female sex when comparing the different results within the matched pairs. That was also confirmed on comparing sex within the individual surgical procedures. No sex-specific differences were identified for the postoperative complications, complication-related reoperations or recurrences. Less favorable intraoperative complication results in the female sex were observed only for the onlay technique.

Conclusions

Female sex is an independent risk factor for chronic pain after elective incisional hernia repair.
Literature
10.
go back to reference Kroese LF, Gillion JF, Jeekel J, Kleinrensink GJ, Lange JF, the Hernia-Club Members (2018) Primary and incisional ventral hernias are different in terms of patient characteristics and postoperative complications—a prospective cohort study of 4565 patients. Int J Surg 51:114–119CrossRefPubMed Kroese LF, Gillion JF, Jeekel J, Kleinrensink GJ, Lange JF, the Hernia-Club Members (2018) Primary and incisional ventral hernias are different in terms of patient characteristics and postoperative complications—a prospective cohort study of 4565 patients. Int J Surg 51:114–119CrossRefPubMed
17.
go back to reference Köckerling F, Bittner R, Kofler M, Mayer F, Adolf D, Kuthe A, Weyhe D (2019) Lichtenstein versus total extraperitoneal patch plasty versus transabdominal patch plasty technique for primary unilateral inguinal hernia repair. Ann Surg 269:351–357. 10/1097/SLA.0000000000002541 Köckerling F, Bittner R, Kofler M, Mayer F, Adolf D, Kuthe A, Weyhe D (2019) Lichtenstein versus total extraperitoneal patch plasty versus transabdominal patch plasty technique for primary unilateral inguinal hernia repair. Ann Surg 269:351–357. 10/1097/SLA.0000000000002541
20.
go back to reference Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RKF, Simons MP, Smietanski M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13:407–414. https://doi.org/10.1007/s10029-009-0518-x CrossRefPubMedPubMedCentral Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RKF, Simons MP, Smietanski M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13:407–414. https://​doi.​org/​10.​1007/​s10029-009-0518-x CrossRefPubMedPubMedCentral
24.
go back to reference Kurzer M, Kark A, Hussain ST (2010) Chronic pain after open mesh repair of incisional hernia. In: Schumpelick et al (eds) Hernia repair sequelae. Springer, Heidelberg Kurzer M, Kark A, Hussain ST (2010) Chronic pain after open mesh repair of incisional hernia. In: Schumpelick et al (eds) Hernia repair sequelae. Springer, Heidelberg
Metadata
Title
Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison
Authors
F. Köckerling
H. Hoffmann
D. Adolf
D.Weyhe
W. Reinpold
A. Koch
P. Kirchhoff
Publication date
01-06-2020
Publisher
Springer Paris
Published in
Hernia / Issue 3/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-019-02089-2

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