TY - JOUR

T1 - High complication rates during and after repeated Lichtenstein or laparoscopic inguinal hernia repairs in the same groin

T2 - a cohort study based on medical records

AU - Öberg, S.

AU - Jessen, M. L.

AU - Andresen, K.

AU - Rothman, J. V.

AU - Rosenberg, J.

PY - 2020

Y1 - 2020

N2 - Purpose: Performing two anterior or two posterior inguinal hernia repairs in the same groin contradict guidelines. Nevertheless, there can be indications for using the same approach at reoperation, and information on complications other than the risk of a third repair and chronic pain is lacking in the literature. The aim was to assess intraoperative events and postoperative complications after two Lichtenstein repairs or laparoscopic inguinal hernia repairs in the same groin. Methods: This nationwide cohort study included patients that had received two Lichtenstein repairs (Lichtenstein–Lichtenstein) or two laparoscopic (Laparoscopy–Laparoscopy) inguinal hernia repairs in the same groin. Patients were identified in the Danish Hernia Database and outcomes were identified in medical records during a period of 6 years. Outcomes were intraoperative events that deviated from a standard repair and 1-year postoperative complications classified according to the Clavien–Dindo classification. Outcomes were reported separately for the two cohorts. Results: Among the included 102 Lichtenstein reoperations, 27% of the repairs had intraoperative events, with drain placement being most common (10%). Half of the reoperations resulted in complications where infection (15%) and hematoma (12%) were most frequent. Among the 58 laparoscopic reoperations, 16% had an intraoperative event where bleeding requiring clips was most common (10%). Half of the reoperations resulted in a complication with surgery in general anesthesia in the same groin area being the most frequent complication (9%). Conclusions: Intraoperative events and 1-year postoperative complications were high for both Lichtenstein–Lichtenstein and Laparoscopy–Laparoscopy, and the results therefore support guidelines that recommend another approach at reoperation.

AB - Purpose: Performing two anterior or two posterior inguinal hernia repairs in the same groin contradict guidelines. Nevertheless, there can be indications for using the same approach at reoperation, and information on complications other than the risk of a third repair and chronic pain is lacking in the literature. The aim was to assess intraoperative events and postoperative complications after two Lichtenstein repairs or laparoscopic inguinal hernia repairs in the same groin. Methods: This nationwide cohort study included patients that had received two Lichtenstein repairs (Lichtenstein–Lichtenstein) or two laparoscopic (Laparoscopy–Laparoscopy) inguinal hernia repairs in the same groin. Patients were identified in the Danish Hernia Database and outcomes were identified in medical records during a period of 6 years. Outcomes were intraoperative events that deviated from a standard repair and 1-year postoperative complications classified according to the Clavien–Dindo classification. Outcomes were reported separately for the two cohorts. Results: Among the included 102 Lichtenstein reoperations, 27% of the repairs had intraoperative events, with drain placement being most common (10%). Half of the reoperations resulted in complications where infection (15%) and hematoma (12%) were most frequent. Among the 58 laparoscopic reoperations, 16% had an intraoperative event where bleeding requiring clips was most common (10%). Half of the reoperations resulted in a complication with surgery in general anesthesia in the same groin area being the most frequent complication (9%). Conclusions: Intraoperative events and 1-year postoperative complications were high for both Lichtenstein–Lichtenstein and Laparoscopy–Laparoscopy, and the results therefore support guidelines that recommend another approach at reoperation.

KW - Inguinal hernia reoperation

KW - Intraoperative complications

KW - Lichtenstein

KW - Postoperative complications

KW - TAPP

UR - http://www.scopus.com/inward/record.url?scp=85076744595&partnerID=8YFLogxK

U2 - 10.1007/s10029-019-02083-8

DO - 10.1007/s10029-019-02083-8

M3 - Journal article

C2 - 31820186

AN - SCOPUS:85076744595

VL - 24

SP - 801

EP - 810

JO - Hernia : the journal of hernias and abdominal wall surgery

JF - Hernia : the journal of hernias and abdominal wall surgery

SN - 1265-4906

IS - 4

ER -