Sliding inguinal hernia is a risk factor for recurrence.

Andresen, Kristoffer; Bisgaard, Thue; Rosenberg, Jacob

PURPOSE A sliding inguinal hernia is defined as a hernia where part of the hernial sac wall is formed by an organ, e.g., the colon or bladder. Thus, repair of a sliding inguinal hernia may have higher risk of complications and recurrence compared with non-sliding inguinal hernia. The aim of this study was to investigate the incidence and reoperation rates following sliding inguinal hernia repair. METHODS This study was based on data from the Danish Hernia Database covering the period between January 1, 1998 and February 22, 2012. Data were collected prospectively and nationwide. RESULTS In total, 70,091 primary hernia repairs were included for analysis. The occurrence of sliding inguinal hernias of the total group of included hernia repairs was 9.4 % among males and 2.9 % among females (p < 0.05). Among male patients, the sliding inguinal hernias had a higher cumulated reoperation rate compared with non-sliding inguinal hernias (6.0 versus 4.2 %, log-rank p = 0.001). A Cox regression model was fitted and showed that the type of repair affected the risk for reoperation for recurrence; hazard ratio (95 % confidence interval): open non-mesh: reference, Lichtenstein 0.43 (0.39-0.48), other open mesh 0.46 (0.39-0.54), laparoscopic 0.70 (0.60-0.84). CONCLUSION The incidence of sliding inguinal hernia is higher in males than in females, and sliding inguinal hernia is a risk factor for reoperation for recurrence. The Lichtenstein repair could be considered over the laparoscopic approach because of lower reoperation rates.