There is insufficient epidemiologic evidence to draw meaningful conclusions about ( i ) the existence of causal associations between specific occupational mechanical exposures and the development of inguinal hernia , and ( ii ) the influence of these exposures on prognosis after inguinal hernia repair with respect to hernia recurrence and persistent pain
OBJECTIVES The aim of this review was to evaluate the epidemiologic evidence for ( i ) a causal effect of occupational mechanical exposures on incidence of inguinal hernia , and ( ii ) a prognostic effect of such exposures on hernia recurrence and persistent pain after inguinal hernia repair .
Quality assessment of 26 304 herniorrhaphies in Denmark: a prospective nationwide study
BACKGROUND Groin hernia repair is one of the most frequent operations , but there is no consensus about surgical or anaesthetic technique . Furthermore , no nationwide studies have been done . Our aim was to investigate outcome results of groin hernia surgery to improve quality of treatment . METHODS We prospect ively recorded 26304 groin hernia repairs done in Denmark from Jan 1 , 1998 , to June 30 , 2000 , in a nationwide Danish hernia data base . FINDINGS 93 % of all groin herniorrhaphies done in Denmark in the 30 months of the study were recorded in the data base . Kaplan-Meier estimates of reoperation rates 30 months after anterior mesh repair and laparoscopic repair were significantly lower than after sutured posterior wall repairs in primary inguinal hernia ( 2.2 % and 2.6 % vs 4.4 % ; p<0.0001 ) . Reoperation rates were also lower with anterior mesh repair ( 6.1 % ; p<0.0001 ) and laparoscopic repair ( 3.4 % ; p<0.0001 ) than with sutured posterior wall repair ( 10.6 % ) after recurrent hernia . Use of Lichtenstein mesh repair  increased from 33 % in January , 1998 , to 62 % in June , 2000 , whereas use of laparoscopic repair remained constant at about 5 % . Kaplan-Meier estimates of reoperation rates were 2.8 % in the first 15 months and 1.6 % in the second ( p=0.03 ) . For elective repairs , only 59 % of patients were treated on an outpatient basis , and only 18 % had local anaesthesia . INTERPRETATION Mesh repairs have a lower reoperation rate than conventional open repairs . Systematic prospect i ve recording of treatment and outcome variables in a national clinical data base improved the overall quality of surgical care . However , there is a large potential for cost savings and more efficient patient care with extended use of mesh techniques , outpatient surgery , and local anaesthesia
There is insufficient epidemiologic evidence to draw meaningful conclusions about ( i ) the existence of causal associations between specific occupational mechanical exposures and the development of inguinal hernia , and ( ii ) the influence of these exposures on prognosis after inguinal hernia repair with respect to hernia recurrence and persistent pain
OBJECTIVES The aim of this review was to evaluate the epidemiologic evidence for ( i ) a causal effect of occupational mechanical exposures on incidence of inguinal hernia , and ( ii ) a prognostic effect of such exposures on hernia recurrence and persistent pain after inguinal hernia repair .