COMMENTARY

A Closer Look at Inguinal Hernia Recurrence Rates

Albert B. Lowenfels, MD

Disclosures

November 02, 2017

The aim of a report published in Surgery[1] was to estimate the proportion of primary hernias that recur in a sample of approximately half a million patients. To determine recurrence rates, the authors captured data from two large nationwide databases, along with information from three Mayo Clinic centers. In the nationwide data sets, the overall hernia recurrence rate ranged from about 10.5% to 11% in males and about 6% to 7% in females; in the Mayo Clinic patients, the results were similar but somewhat higher.

In multivariate analysis, recurrent hernias were about twice as likely to develop in males as in females and increased with age, inpatient status, and obesity. There was no change over the period from 2005 to 2014.

Viewpoint

The main finding in this large study is that hernia recurrence rates appear to be much higher than suspected from smaller, individual reports. The recurrence rates reported here closely match the 10%-15% recurrence rate in Scandinavian hernia registries.[2] Furthermore, the increasing use of laparoscopic repair during the study period does not appear to have reduced the frequency of hernia recurrence.

One weakness of the study is that the individual patient data necessary for accurate follow-up were not readily attainable. The authors suggest that establishing a hernia registry to follow patients would increase the accuracy of current estimates and provide outcome information leading to reductions in recurrence rates.

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