Hernia最新文献

{"title":"French nationwide monthly online consultation meeting on complex abdominal wall repairs: 4-year assessment of an innovative collaborative decision-making tool.","authors":"Gaëtan-Romain Joliat, Jean-François Gillion, Grégory Baud, Benoît Romain, Yohann Renard, Pablo Ortega-Deballon, Vincent Dubuisson, Haitham Khalil, David Moszkowicz, Guillaume Passot","doi":"10.1007/s10029-025-03483-9","DOIUrl":"https://doi.org/10.1007/s10029-025-03483-9","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment of complex cases of abdominal wall reconstruction (AWR) has become more frequent, and management options are diverse. Treatment decision could be improved using a multicentric consultation meeting. The aim of this study was to assess quantitatively and qualitatively the outcomes of the French national online consultation meeting (OCM).</p><p><strong>Methods: </strong>The OCM was implemented in January 2021. This is an OCM where all surgeons working in France can present their cases of complex AWR for opinion. Descriptive statistics on this OCM were collected from implementation to March 2025. Moreover, a survey on how participating surgeons perceived this OCM was performed.</p><p><strong>Results: </strong>During the study period, a total of 436 cases were presented at the OCM (384 ventral hernias, 88% and 52 groin hernias, 12%). Overall, 127 surgeons participated in the OCM. The majority of presented patients originated from university hospitals (n = 294, 68%). Thirty-one surgeons (31/127 = 24%) who participated in the OCM answered the survey. Most surgeons found that the OCM had a very high pedagogical interest (median 9/10, IQR 8-10). In total, 30/31 surgeons (97%) would recommend to a colleague to take part in this OCM. Among surgeons who presented a case and answered the survey (n = 24), 1 (4%), 10 (42%), and 13 (54%) surgeons found the OCM useful, very useful, and indispensable, respectively. All surgeons who responded were satisfied with the OCM (21 were very satisfied, 87%).</p><p><strong>Conclusions: </strong>Implementation of a nationwide OCM for complex AWR is feasible and sustainable. Feedbacks from participants emphasized the usefulness of this meeting designed to help surgeons to better tailor treatment to patients with complex hernias. However, as patient outcomes were not available, precluding any analyses on the impact of the OCM on patient postoperative evolution, further follow-up results will be needed.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"288"},"PeriodicalIF":2.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic burden and determinants of hospitalization costs in patients undergoing parastomal hernia repair: a quantile regression analysis.","authors":"Xiaoli Liu, Qiuyue Ma, Yingmo Shen, Shen","doi":"10.1007/s10029-025-03485-7","DOIUrl":"https://doi.org/10.1007/s10029-025-03485-7","url":null,"abstract":"<p><strong>Background: </strong>Parastomal hernia (PSH) repair imposes substantial economic burdens, yet factors influencing hospitalization costs remain inadequately characterized. Quantile regression provides insights into cost determinants beyond traditional mean-based analyses. This study aimed to identify key predictors of hospitalization costs associated with PSH repair using quantile regression.</p><p><strong>Methods: </strong>This retrospective study included patients undergoing PSH repair at Beijing Chao-Yang Hospital (2012-2024). Hospitalization cost data, demographic variables, clinical characteristics, and procedural details were collected. Quantile regression was utilized to examine cost determinants across hospitalization cost quantiles (10th-90th percentiles). Regression coefficients (β) are interpreted on the outcome scale, with β denoting the adjusted cost difference in Chinese Yuan (CNY) for indicator variables and the adjusted change in cost per one-unit increase for continuous variables (CNY per unit), and positive values indicate higher costs while negative values indicate lower costs. All costs are reported in Chinese Yuan (RMB; ¥1 ≈ 0.14 United States Dollar [USD] and ≈ 0.13 Euro [EUR], based on 2024 average exchange rate).</p><p><strong>Results: </strong>A total of 1,113 patients were included, of whom 571 (51.3%) were male, and 740 (66.5%) were aged ≥ 65 years. Univariate analysis showed that hospitalization costs differed significantly by patient source, age group, occupation, payment method, admission year, ICU use, length of stay, number of comorbidities, surgery type and level, concurrent hernia surgeries, bowel resection, additional procedures, mesh use, and ventilator use (all P < 0.05). From 2012 to 2022, the mean hospitalization cost increased from ¥42,388 to ¥73,459, before slightly declining to ¥60,276 in 2024; materials consistently accounted for over 50% of the total cost. Quantile regression revealed that mesh use (β = 25,784 to 36,229), laparoscopic surgery (β = 7,359 to 17,813), and concurrent hernia surgeries (β = 9,409 to 14,447) significantly increased costs across all quantiles (all P < 0.001). Length of stay (β = 543 to 894) and number of comorbidities (β = 424 to 646) were also significantly associated with costs at all quantiles (P < 0.05). Ventilator use was associated with higher costs at the 30th, 40th, 50th, and 90th quantiles, peaking at the 90th (β = 17,088; P < 0.001). Level 4 surgery increased costs significantly from the 10th to 40th quantiles (β = 8,596 to 16,634; all P ≤ 0.040).</p><p><strong>Conclusions: </strong>Hospitalization costs for PSH repair vary statistically significantly by clinical complexity, surgical approach, socioeconomic status, and procedural resource intensity. These findings highlight the need to incorporate economic considerations into clinical decision-making and healthcare policy.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"290"},"PeriodicalIF":2.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of anterior component separation versus posterior component separation with transversus abdominis muscle release for large incisional hernias: a systematic review and meta-analysis.","authors":"Ali Yasen Mohamedahmed, Mohamed Talaat Issa, Shafquat Zaman, Safeya Mohammed, Marwa Yassin Mohamedahmed, Mohammed Hamid, A K Ali Muhammed, Stephen Odogwu, Syed Adnan Kabir","doi":"10.1007/s10029-025-03487-5","DOIUrl":"https://doi.org/10.1007/s10029-025-03487-5","url":null,"abstract":"<p><strong>Background: </strong>Large incisional hernias (IHs), especially with loss of domain, pose significant challenges for repair. Component separation, as a method of repair, allows for adequate coverage of large hernial defects. We compared outcomes of anterior component separation (ACS) versus posterior component separation with transversus abdominis muscle release (PCSTAR) in the repair of large IHs.</p><p><strong>Methods: </strong>A systematic search of various electronic databases was conducted to identify studies (published between January 1990 - June 2025) comparing ACS and PCSTAR performed for IH repair. The included studies were assessed for risk of bias (RoB) using validated tools appropriate to study design (Cochrane RoB for randomised controlled trials (RCTs), MINORS for non-randomised studies). Our evaluated outcome measures included overall wound complications, surgical site infections (SSI), hematoma and seroma formation, total operative time, length of hospital stay (LOS), and recurrence rate. Data were analysed using RevMan 5.3, employing a random-effects model.</p><p><strong>Results: </strong>A total of eight studies (three RCTs and five observational studies) with 2293 patients (1573 with ACS and 720 with PCSTAR) were included. The PCSTAR group demonstrated a lower rate of overall wound complications (odds ratio [OR] 2.58, P = 0.004) and SSIs (OR 1.72, P = 0.05) compared with the ACS group. No significant differences were observed for hematoma (OR 0.87, P = 0.51) or seroma formation (OR 1.77, P = 0.11), recurrence rate (OR 1.81, P = 0.31), operative time (mean difference [MD] -6.57, P = 0.77), or LOS (MD -0.67, P = 0.16) between the two groups. Overall, RCTs demonstrated a low risk of bias in most domains, whilst non-randomised studies showed moderate methodological quality.</p><p><strong>Conclusion: </strong>Both component separation techniques demonstrated comparable outcomes and efficacy in the repair of large incisional ventral hernias (IVHs). However, PCSTAR seems to be associated with reduced overall wound complications and SSI rates. A small number of included RCTs mandate that further adequately powered, well-designed RCTs are required to validate these findings.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"289"},"PeriodicalIF":2.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico-legal case series of litigation involving chronic post-herniorrhaphy inguinal pain: insights from Italian civil verdicts.","authors":"Roberto Cirocchi, Luca Tomassini, Salvatore Guarino, Andrea Mingoli, Diletta Cassini, Bruno Cirillo, Massimo Lancia, Piergiorgio Fedeli, Paolo Bruzzone","doi":"10.1007/s10029-025-03472-y","DOIUrl":"https://doi.org/10.1007/s10029-025-03472-y","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic postherniorrhaphy inguinal pain (CPIP) is a recognized postoperative complication and a potential trigger for malpractice litigation. This case series presents a descriptive medicolegal analysis of civil verdicts involving CPIP following inguinal hernia repair in Italy.</p><p><strong>Methods: </strong>A retrospective review was performed using the Italian Ministry of Justice's Banca Dati di Merito, examining malpractice verdicts from 2015 to 2025 related to CPIP after hernioplasty. Seventeen cases met the inclusion criteria. Variables collected included type of nerve injury, surgical technique, fixation method, informed consent, reinterventions, and symptom profile. Data were summarized using descriptive statistics.</p><p><strong>Results: </strong>Compensation was awarded in 4 of 17 cases (23.5%). Nerve injury was documented in 13 cases (76.5%), with genitofemoral nerve involvement in 6 of these (46.2%). Among the six cases with genitofemoral injury, four received compensation (66.7%), while no compensation occurred in cases without such injury. Neurectomy was performed in 5 cases, three of which resulted in compensation (60.0%) compared with 1 of the 12 cases without neurectomy (8.3%). Informed consent forms were available in 5 cases; in three of these, the risk of nerve injury was omitted, with one case leading to compensation.</p><p><strong>Conclusion: </strong>This descriptive case series highlights a potential association between genitofemoral nerve injury and compensation outcomes in CPIP-related litigation. In most cases involving genitofemoral injury, compensation was awarded. Neurectomy also appeared to show a trend toward legal relevance. These findings reinforce the medico-legal importance of accurate nerve identification, thorough intraoperative documentation, and attentive postoperative management in hernia surgery. Further prospective studies are warranted to confirm these preliminary observations and inform both surgical and legal best practices.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"287"},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is mental training suitable for teaching a surgical procedure to students? A single-center study using a hernia model.","authors":"Miro Kopp, Guido Woeste, Hanan El Youzouri, Ursula Pession, Jasmina Sterz, Miriam Ruesseler, Wolf O Bechstein, Teresa Schreckenbach","doi":"10.1007/s10029-025-03466-w","DOIUrl":"10.1007/s10029-025-03466-w","url":null,"abstract":"<p><strong>Purpose: </strong>New methods of teaching surgical skills are in demand. Mental skills training (MST) has been proven effective in the training of surgeons. However, research on medical students is still rare. This explorative study investigates whether a minimalist form of MST can support surgical performance on a hernia model in medical students in a way comparable to students trained using a conventional 'see one, do one' approach.</p><p><strong>Methods: </strong>A novel inexpensive benchtop training model for abdominal wall hernias has been developed. Medical students were randomized into an 'See one, do one' and a 'See one' + MST group. Both groups received the same theoretical instructions, after which a tutor demonstrated the operation on the model. While the first group received training in MST afterwards, the 'See one, do one' group was trained using the benchtop model. Subsequently, both groups performed surgery on the model. Their performance was videotaped and evaluated by experienced surgeons.</p><p><strong>Results: </strong>A total of 44 medical students took part in the study. The 'See one, do one' group performed significantly better in the professional examination, although the consistency of the stitching was comparable between the two groups and showed no statistically significant differences.</p><p><strong>Conclusion: </strong>'See one' + MST group alone without practical training did not result in comparable performance as the 'See one, do one' approach in our study. The MST group performed inferiorly across most objective metrics. While this suggest that MST in isolation may not be sufficient for teaching complex procedures to medical students, it highlights the importance of practical exposure. The potential benefit of combining MST with hands-on training should be investigated in future studies, but cannot be inferred from the current data.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"286"},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12494617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in hernia-related mortality among older adults in the U.S.: A 21-year analysis of the CDC-WONDER database.","authors":"Shree Rath, Hira Hameed, Saif Ur Rahman, Muhammad Ali, Muhammad Sohaib, Mishaim Khan, Shabir Muhammad","doi":"10.1007/s10029-025-03464-y","DOIUrl":"https://doi.org/10.1007/s10029-025-03464-y","url":null,"abstract":"<p><strong>Introduction: </strong>Hernias are common conditions often requiring surgical intervention. Despite advancements in medical techniques, hernia-related mortality remains a significant concern, particularly among older adults. This study aims to analyze the mortality trends and disparities in hernia-related deaths among U.S. adults aged 65 and older over a 21-year period, focusing on demographic and geographic discrepancies.</p><p><strong>Methods: </strong>Data from the CDC-WONDER database, spanning from 1999 to 2020, was used to identify hernia-related deaths among individuals aged 65 and older, classified by ICD-10 codes K40-46. Mortality rates were stratified by age, sex, race, geography, and place of death. Annual age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. population as a baseline, and trends were analyzed using Joinpoint regression v.5.2.0 to estimate annual percent changes (APCs) and overall average annual percent changes (AAPCs) from 1999 to 2020.</p><p><strong>Results: </strong>The study identified 32,597 hernia-related deaths in older adults, with a predominance in females (61.39%) over males (38.61%). AAMR values showed stability overall but were consistently higher among older men (3.54 per 100,000 95% CI: 3.48-3.60) compared to older women (3.52 per 100,000, 95% CI: 3.47-3.57). Racial disparities were notable, with non-Hispanic Whites exhibiting the highest AAMRs (3.66 per 100,000) with a rising trend ((AAPC NH White: 0.46; 95% CI: 0.22 to 0.73)), while non-Hispanic Black and Hispanic populations showed declining or stable trends. Throughout the study duration, rural areas had higher overall AAMRs versus urban areas, with overall AAMR values of 4.07 (95% CI: 3.98-4.17) and 3.43 (95% CI: 3.38-3.47), CONCLUSION: While overall hernia-related mortality rates have remained stable, significant demographic and geographic disparities persist. Older men, non-Hispanic Whites, and residents of rural areas and the Midwest are at higher risk. These findings highlight the need for targeted public health interventions to address these disparities and reduce the mortality burden from hernias among older adults.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"285"},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic repair of off-midline abdominal wall hernias: a single institution consecutive case series.","authors":"Priti Dutta, Gina Kim, Nathan English, Tapasya Katta, Gurudatta Naik, Margaux Mustian, Britney Corey, Abhishek D Parmar","doi":"10.1007/s10029-025-03476-8","DOIUrl":"10.1007/s10029-025-03476-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;While off-midline hernias represent only a small percentage of abdominal wall defects, symptoms can be debilitating for the affected patients, and repair portends substantial operative challenges for the surgeon. There are no large-scale case series that describe outcomes with extraperitoneal repair using the robotic approach. The objective of this study was to describe our experience of patients undergoing robotic repair of off-midline hernias at a tertiary care medical center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was a retrospective review of patients who underwent elective robotic repair of off-midline hernias from June 2019 to October 2024. All adults (≥ 18 years old) diagnosed with a primary (no prior repair) or recurrent off-midline hernia were included. Patient demographics, preoperative clinical variables (smoking status, BMI, ASA score, co-morbidities, presence of pain, hernia type, history of prior hernia repair, type of prior flank operation, and dimensions of the hernia on CT scan), operative variables (perioperative regional pain blocks, operative approach, type and dimensions of mesh used), and postoperative outcomes (hospital length of stay (LOS), follow-up duration, hernia recurrences, and complications including wound occurrences and chronic pain defined as pain &gt; 3 months postop) were abstracted from a prospectively maintained hernia database. Univariate analyses were used to measure and describe all covariates and outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 43 patients included in the study. Patients had an average age of 57.5 years and an average BMI of 32.8 kg/m2. 81% of the cohort identified as White race and 65% were female. 26% of the cohort had diabetes mellitus (average HbA1c 5.8), 7% had a smoking history, and 9% had COPD. Most hernias were incisional (51%) or traumatic (47%). Average hernia length and width were 8.0 ± 4.5 and 6.7 ± 2.7 cm. 98% had a clean wound classification. Fascial closure was performed in 86% of the cases and a mesh was placed in 98% of the cases. Average mesh length and width were 21.2 ± 5.9 and 21.1 ± 5.1 cm. There were 6 (14%) hybrid procedures, where the hernia was repaired via a combination of a robotic and open approach. Average hospital length of stay was 1.9 days and average follow up was 4.4 months. There were two (5%) recurrences. There were 15 (35%) postoperative complications. The most common complications were seroma (14%), hematoma (7%) and persistent pain &gt; 3 months (5%). One patient (2%) developed an abscess, two patients (5%) had a nerve injury, and one patient (2%) had a postoperative small bowel obstruction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Robotic off-midline hernia repair can be performed with minimal morbidity. Most common complication was postoperative seroma. Surgical outcomes were similar to existing literature on outcomes following open repair. Surgeons performing this repair should appropriately counsel their patients on ","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"283"},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preperitoneal bupivacaine instillation in addition to TAP block for pain control in laparoscopic inguinal hernia repair: a randomised controlled trial.","authors":"Wanicha Lertpipopmetha, Kornkanok Yuwapattanawong, Pakkapol Sukhvibul, Poramet Leungon, Amarit Tansawet, Witchapas Punyanirun, Suphakarn Techapongsatorn","doi":"10.1007/s10029-025-03474-w","DOIUrl":"10.1007/s10029-025-03474-w","url":null,"abstract":"<p><strong>Purpose: </strong>Enhanced Recovery After Surgery (ERAS) protocols highlight the importance of effective perioperative pain management to facilitate early ambulation and discharge following laparoscopic inguinal hernia repair. While transversus abdominis plane (TAP) block provides effective analgesia, its duration is typically limited to 24 h. This study aimed to evaluate whether adding preperitoneal instillation of bupivacaine to TAP block improves early postoperative pain control.</p><p><strong>Methods: </strong>This triple-blinded, randomised controlled trial included adult patients undergoing elective laparoscopic inguinal hernia repair at Vajira Hospital. All patients received a TAP block with 0.25% bupivacaine. After mesh placement, patients were randomised to receive either preperitoneal instillation of 10 mL normal saline (control group) or 10 mL of 0.25% bupivacaine (intervention group). Primary outcome was pain intensity (VAS score) at 6 and 24 h postoperatively. Secondary outcomes included operative time, estimated blood loss, postoperative complications, and length of hospital stay.</p><p><strong>Results: </strong>Sixty patients were randomised (30 per group). The groups were comparable in baseline characteristics and surgical variables. The intervention group also had significantly lower VAS scores at 48 h (1.03 ± 1.12 vs 2.10 ± 1.36; p = 0.002). Functional recovery parameters and satisfaction scores were similar between groups. There were no significant differences in operative time, blood loss, or postoperative complications.</p><p><strong>Conclusion: </strong>The addition of preperitoneal bupivacaine instillation to TAP block significantly improves early postoperative pain control after laparoscopic inguinal hernia repair without increasing complication rates. This simple and safe technique complements multimodal analgesia strategies and supports ERAS objectives in minimally invasive hernia surgery.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"284"},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of serum levels of matrix metalloproteinases and their inhibitors in the etiology of inguinal hernia.","authors":"Hasan Basoglu, Fatih Yanar, Berke Sengun, Ibrahim Fethi Azamat, Hakan Yanar, Elif Ozkok","doi":"10.1007/s10029-025-03477-7","DOIUrl":"https://doi.org/10.1007/s10029-025-03477-7","url":null,"abstract":"<p><strong>Aim: </strong>Inguinal hernias are one of the most common operations performed worldwide, but etiopathogenesis remains important in current practice. Recent studies have frequently examined factors affecting the extracellular matrix and collagens and their association with hernias. This study aimed to investigate the role of matrix metalloproteinases (MMPs) and their inhibitors in the etiopathogenesis of inguinal hernia.</p><p><strong>Methods: </strong>Serum samples obtained from 90 male inguinal hernia patients and 70 male control patients who presented to our clinic between March 15, 2024, and September 30, 2024, were analyzed using the ELISA method. Serum levels of matrix metalloproteinases (MMP-1, MMP-8, MMP-13) and tissue inhibitors of metalloproteinases (TIMP-1, TIMP-2) were measured. The serum level results were compared in terms of net MMP activity, which was determined by calculating the MMP/TIMP ratios.</p><p><strong>Results: </strong>The serum level of MMP-1 was found to be significantly higher in the hernia group (9.1 vs. 7.5; p < 0.001). No significant differences were observed in the levels of other enzymes. In terms of net MMP activity, the ratios of MMP-1/TIMP-1 (hernia: 1.1 vs. control: 0.8, p = 0.01), MMP-1/TIMP-2 (hernia: 0.3 vs. control: 0.2, p < 0.001), and MMP-13/TIMP-2 (hernia: 0.14 vs. control: 0.11, p = 0.046) were higher in the hernia group, whereas the MMP-8/TIMP-1 ratio (hernia: 4.5 vs. control: 7.0, p = 0.017) was lower.</p><p><strong>Conclusion: </strong>In the inguinal hernia group, the serum level of MMP-1 and net MMP activity were increased, while the MMP-8/TIMP-1 ratio was decreased compared to the control group. These findings suggest that these markers may play a role in the etiopathogenesis of hernia.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"280"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the association between BMI classes and the outcome in incisional hernia repair?","authors":"F Köckerling, K Zarras, R Schwab, H Niebuhr, W Reinpold, H Riediger, F Mayer, B Stechemesser, J Conze, R Lorenz, R Fortelny","doi":"10.1007/s10029-025-03437-1","DOIUrl":"https://doi.org/10.1007/s10029-025-03437-1","url":null,"abstract":"<p><strong>Introduction: </strong>The percentage of people who are overweight or obese is increasing worldwide. Already today, almost three billion out of 8.2 billion people are overweight. Patients with overweight or obesity are at a higher risk of developing incisional hernias following abdominal procedures. Registry data on open ventral hernia repair reveal rates of 58.5% in the presence of obesity. There are very few studies on the outcome of incisional hernia repair in relation to BMI classes.</p><p><strong>Materials and methods: </strong>In a retrospective study of data on incisional hernias in the Herniamed Registry, multivariable analysis of potential confounding factors on the outcome was carried out. The prime focus was on the association of BMI classes, as defined by WHO.</p><p><strong>Results: </strong>Following patient selection, 42,081 patients were included in the analysis (normal weight: 22.9%; overweight: 38.5%, and obesity: 38.5%). No association was found between the outcome and the BMI classes with regard to the intraoperative complications, general complications or chronic pain requiring treatment. An unfavorable relationship was identified between higher BMI classes and the postoperative complications, complication-related reoperations and recurrences. A favorable relationship was seen between higher BMI classes and chronic pain at rest and on exertion.</p><p><strong>Conclusion: </strong>Since higher BMI classes have a very negative association with the outcome in incisional hernia repair with regard to postoperative complications, complication-related reoperations and recurrence, preoperative weight loss seems to be an important measure to avoid complications and recurrences.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"278"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}