Abstract
Purpose
It has been estimated in the UK that 27 % of men and 3 % of women will undergo an inguinal hernia repair (IHR) during their lifetimes. However, no epidemiologic study investigating IHR has been performed to date in an Asian population. The present study explored the incidence and recurrence of IHR in an Asian population using a nation-wide population-based dataset in Taiwan.
Methods
Based on the National Health Insurance Database, we identified 5806 patients who underwent an IHR between 2000 and 2010 and followed them until they had a recurrence, died during hospitalization, left the program, or the study ended. We calculated the age-stratified recurrence rates and used Cox proportional hazards to explore the influence of demographic and clinical factors on recurrence. We also plotted IHR occurrence over the study period.
Results
Among the 5806 sampled subjects who had an IHR, 565 (9.73 %) had an IHR recurrence yielding an overall incidence of 18.23 per 1000 person-years. The hazard ratios for recurrence increased with age, and were greater among men and blue collar workers. The incidence of IHR decreased from 168.21 to 92.10 per 100,000 person-years over the study period. Surgical complication rates ranged between 0.16 and 2.57 %.
Conclusions
On account of the increased risk of recurrence with age, young hernia patients may not want to delay surgery. This study detected a decreasing trend in initial IHR rates, confirming similar trends reported in Western countries. However, the incidence of initial IHR is lower in Taiwan than it is in the West.
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References
Primatesta P, Goldacre MJ (1996) Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol 25:835–839
Zendejas B, Ramirez T, Jones T et al (2013) Incidence of inguinal hernia repairs in Olmsted County, MN: a population-based study. Ann Surg 257:520–526
Pokorny H, Klingler A, Schmid T et al (2008) Recurrence and complications after laparoscopic versus open inguinal hernia repair: results of a prospective randomized multicenter trial. Hernia 12:385–389
Phillips W, Goldman M (2004) Groin Hernia. Health care needs assessment, the epidemiologically based needs assessment reviews. First series, vol 1, 2nd edn. Radcliffe Publishing UK
Kingsnorth A, LeBlanc K (2003) Hernias: inguinal and incisional. Lancet 362:1561–1571
Nilsson E, Kald A, Anderberg B et al (1997) Hernia surgery in a defined population: a prospective 3 year audit. Eur J Surg 163:823–829
Haapaniemi S, Nilsson E (2002) Recurrence and pain 3 years after groin hernia repair. Validation of postal questionnaire and selective physical examination as a method of follow-up. Eur J Surg 168:22–28
Rosemar A, Angerås U, Rosengren A, Nordin P (2010) Effect of body mass index on groin hernia surgery. Ann Surg 252:397–401
van der Linden W, Warg A, Nordin P (2011) National register study of operating time and outcome in hernia repair. Arch Surg 146:1198–1203
Magnusson N, Nordin P, Hedberg M, Gunnarsson U, Sandblom G (2010) The time profile of groin hernia recurrences. Hernia 14:341–344
Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jorgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140:119–123
Ruhl CE, Everhart JE (2007) Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol 165:1154–1161
Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am 83:1045–1051
Abramson JH, Gofin J, Hopp C et al (1978) The epidemiology of inguinal hernia. A survey in western Jerusalem. J Epidemiol Community Health 32:59–67
Burcharth J, Pedersen M, Bisgaard T et al (2013) Nationwide prevalence of groin hernia repair. PLoS One 8:e54367
Ansaloni L, Coccolini F, Fortuna D et al (2014) Assessment of 126,913 inguinal hernia repairs in the Emilia-Romagna region of Italy: analysis of 10 years. Hernia 18:261–267
Fitzgibbons RJ Jr, Giobbie-Hurder A, Gibbs JO et al (2006) Watchful waiting vs repair of inguinal hernia in minimally symptomatic men: a randomized clinical trial. JAMA 295:285–292
Oberlin P, Boudet MJ, Vyrieres M et al (1995) French Associations for Surgical Research. Recurrence after inguinal hernia repair: prognostic facts in a prospective study of 1706 hernias. Br J Surg 82(suppl 1):65
Neumayer L, Giobbie-Hurder A, Jonasson O et al (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827
Bay-Nielsen M, Thomsen H, Andersen FH et al (2004) Convalescence after inguinal herniorrhaphy. Br J Surg 91:362–367
Cunningham J, Temple WJ, Mitchell P et al (1996) Cooperative Hernia Study. Pain in the postrepair patient. Ann Surg 224:598–602
Ho CH, Tsai YC (2012) Old age is a risk factor for recurrence after laparoscopic inguinal hernia repair with porcine small intestine submucosa mesh. Am Surg 78:497
Lau H, Fang C, Yuen WK et al (2007) Risk factors for inguinal hernia in adult males: a case-control study. Surgery 141:262–266
Carbonell JF, Sanchez JL, Peris RT et al (1993) Risk factors associated with inguinal hernias: a case control study. Eur J Surg 159:481–486
Yeh CJ, Chang HY, Pan WH (2011) Time trend of obesity, the metabolic syndrome and related dietary pattern in Taiwan: from NAHSIT 1993–1996 to NAHSIT 2005–2008. Asia Pac J Clin Nutr 20:292–300
Percentage distribution of Body Mass Index (BMI). Health Promotion Administration, Ministry of Health and Welfare Web. 14 Nov. 2013. https://olap.bhp.doh.gov.tw/Search/search2.aspx?menu=1&mode=3&TarId=157&year=99&NL=1&sel=0#QuerySetting
Aufenacker TJ, de Lange DH, Burg MD et al (2005) Hernia surgery changes in the Amsterdam region 1994–2001: decrease in operations for recurrent hernia. Hernia 9:46–50
Cheng TY, Wen CP, Tsai MC et al (2003) The current status of smoking behavior in Taiwan: data analysis from National Health Interview Survey in 2001. (in Chinese). Taiwan J Public Health 22:453–464
Percentage reported being a smoker. Health Promotion Administration, Ministry of Health and Welfare Web. 14 Nov.2013. https://olap.bhp.doh.gov.tw/Search/search2.aspx?menu=1&mode=1&TarId=154&year=98&NL=1&sel=0#QuerySetting
Cannon DJ, Read RC (1981) Metastatic emphysema: a mechanism for acquiring inguinal herniation. Ann Surg 194:270–278
Health and Vital Statistic (2) (1994) Vital Statistic Department of Health. Taiwan: Executive Yuan, R.O.C
Acknowledgments
This study was supported in part by grants from the Clinical Trial and Research Center of Excellence (DOH 100-TD-B-111-004), the Cancer Research Center of Excellence (DOH 100-TD-C-111-005), and Academia Sinica Taiwan Biobank.
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None declared.
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J. J. Keller and C.-H. Muo contributed equally to this manuscript.
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Keller, J.J., Muo, CH., Lan, YC. et al. A nation-wide population-based study of inguinal hernia repair incidence and age-stratified recurrence in an Asian population. Hernia 19, 735–740 (2015). https://doi.org/10.1007/s10029-015-1359-4
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DOI: https://doi.org/10.1007/s10029-015-1359-4