An Analysis Of Risk Factors And Treatment For Inguinal Hernia Recurrence

Objective:The aim of this study is to analysis the risk factors of recurrence after groin hernia surgery,and to compare different treatment for recurrent inguinal hernia.Methods:We collected the clinical data of patients with inguinal hernia,who hospitalized in the first hospital of Lanzhou University and had inguinal hernia surgery during 1^st January 2013 to 25^th November 2016.According to the inclusion and exclusion criteria,1035 patients were included in the study of which 974patients had primary inguinal hernia and 61 patients had recurrent groin hernia.Gender,age,body mass index,smoking history and history of prostatectomy was analyzed.The treatment for recurrent groin hernia and the follow-up data were obtained and analyzed.For patients with recurrent hernia,data with regard to the details of primary operation were also collected and analyzed.Results:The characteristics of all 1035 included patients were analyzed.974patients had primary hernia and 872 of them were male;61 patients had recurrent groin hernia and 51 of them were male.No significant difference was found in gender,age?56.87±17.72 and 60.66±15 respectively?,and smoking history?16.02%and 18.03%respectively?in primary and recurrent group.The average BMI in primary group?22.99±2.91?is significant lower than recurrent group?23.98±2.88?.133 patients in primary group had direct hernia,14 patients had direct hernia in recurrent group,and the difference is statistically significant.For primary operation in patients with recurrent hernia,the numbers of patient who underwent primary surgery with local,regional,and general anesthesia were 4?6.56%?,46?75.41%?,and 11?18.03%?respectively;3 patients?4.35%?had a laparoscopic hernia repair,48patients?69.57%?had open tension-free hernia repair,14 patients?20.28%?had tissue-based tension hernia repair,and 4 patients?5.80%?had hernia ligation.For recurrent hernia repair operation,the number of patient who underwent primary surgery with local,regional,and general anesthesia were 10?16.40%?,26?42.62%?,and 25?40.98%?respectively;29 patients?43.28%?had laparo-endoscopic hernia repair,36 patients?53.73%?had open tension-free hernia repair,2 patients?2.99%?had tissue-based tension hernia repair.The follow-up duration of 61 patients after the operation of recurrent groin hernia is ranged from 18 months to 66 months.Within 6month after the surgery,five patients had scrotal seroma,three patients had ecchymosis,and 1 patient had surgical site infection.All above complications were recovered after expectant treatment.One patient had a recurrence two years after the surgery and has had another operation,two patients had intermittent discomfort in groin area,and 4 patients had hypoesthesia.Conclusion:We found that higher BMI and direct hernia were risk factors for recurrent inguinal hernia;however gender,age,and smoking history do not have a distinct positive correlation with the recurrence of inguinal hernia.The operation performed for recurrent hernia not only depends on how the previous operation was done but also the experience of the surgeon and situation of the patients.It's essential to individualize the treatment.