Hernia最新文献

{"title":"Economic claims following chronic pain after inguinal hernia repair.","authors":"Kenney Fehrenkamp Pedersen, Martin Frimand Rønnow, Thue Bisgaard","doi":"10.1007/s10029-026-03796-3","DOIUrl":"10.1007/s10029-026-03796-3","url":null,"abstract":"<p><strong>Purpose: </strong>Economic claims after surgery may be regarded as an alternative surrogate outcome for long-term deprived quality of life. This study reports economic claims of chronic pain following inguinal hernia repair.</p><p><strong>Methods: </strong>Consecutive data on economic claims following inguinal hernia repair was collected from the nationwide Danish Patient Compensation Association. Patients' claims were stratified into three groups: 1) isolated chronic pain claims without claims of competing potential reasons for chronic pain (ICP); 2) diverse claims not involving claims of chronic pain (NCP); and 3) claims involving a combination of chronic pain and competing potential claim reasons for chronic pain (CCP).</p><p><strong>Results: </strong>A total of 507 patients were included and 256 (50.5%) filed a claim involving chronic pain. Follow-up was 100% and median time from hernia repair to patient filing a claim in the ICP group was 1.5 years (IQR 0.6-2.6 years). ICP, NCP and CCP comprised 172 patients (33.9%), 251 patients (49.5%) and 84 patients (16.6%) respectively. Chronic pain was by far the most common claim reason (33.6% of all claim reasons). The median sum of granted compensation per patient in the ICP, NCP and CCP groups was €14,440 (IQR 7,233-100,600), €6,289 (4,024-12,094) and €7,777 (5,639-11,781) respectively.</p><p><strong>Conclusion: </strong>Long-term chronic pain alone, not involving other complications, was by far the most common reason for seeking economic compensation. Economic compensation of isolated chronic pain (ICP) was rare, but when awarded, was substantially higher than compensation for other claims.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436632","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":"Heterotopic Ossification in Complete Adductor Longus Tears: A Retrospective Analysis of Associated Factors and Surgical Outcomes.","authors":"Alexa De la Fuente Hagopian, Samantha Cervantes Valadez, Lauren Abigail Hoffpauir, Matthew Nungesser, Joshua Harris, Anthony Echo","doi":"10.1007/s10029-026-03764-x","DOIUrl":"10.1007/s10029-026-03764-x","url":null,"abstract":"<p><strong>Purpose: </strong>Heterotopic ossification (HO) is a rare but recognized complication of adductor longus tears, and the factors that predispose patients to its development are not well characterized. The purpose of this study was to identify factors associated with the development of HO following adductor longus tears and to describe outcomes after surgical management.</p><p><strong>Methods: </strong>A retrospective review was conducted of 132 patients surgically treated for adductor longus tears by a single surgeon between January 2016 and January 2025. Patients were classified by tear severity (partial versus complete) and by symptom chronicity (acute versus chronic, using a six-month cutoff). HO was identified on MRI or CT. All patients had failed prior conservative management and underwent surgical excision, with pain and range of motion assessed at six months postoperatively.</p><p><strong>Results: </strong>Of the 132 patients, 87 had partial tears and 45 had complete tears. HO was identified in 10 of 45 patients (22%) with complete tears and in none of the 87 patients with partial tears. Among patients with HO, 60% had acute injuries and 40% had chronic injuries. Surgical excision led to significant improvement in pain and range of motion at six months in all patients.</p><p><strong>Conclusion: </strong>HO following adductor longus injury occurred exclusively in complete avulsions, regardless of injury chronicity, and surgical excision was associated with substantial functional recovery.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435912","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":"Clinical outcomes in abdominal wall autologous flap reconstruction: a systematic review.","authors":"Michalis Hadjiandreou, Sola Kim, Cheuk Ying Kyleen Kiew, Bijendra Patel, Parviz Lionel Sadigh, Gurjinderpal Singh Pahal, David Ross, Georgios Pafitanis","doi":"10.1007/s10029-026-03787-4","DOIUrl":"10.1007/s10029-026-03787-4","url":null,"abstract":"<p><strong>Purpose: </strong>Complex abdominal wall defects present major reconstructive challenges when restoration of fascial continuity must be combined with durable soft-tissuecoverage, visceral protection, and, in selected cases, functional repair. Although autologous flap reconstruction is well established for selected indications, its overall role across defect types has yet to be established.</p><p><strong>Methods: </strong>A systematic review was performed in accordance with PRISMA guidelines (PROSPERO: CRD42023491916). PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar were searched from inception to April 2026 for studies reporting adult autologous flap-based abdominal wall reconstruction. Given substantial clinical and methodological heterogeneity, data were analysed descriptively.</p><p><strong>Results: </strong>172 studies comprising 4,421 patients were included. Pedicled flaps predominated (n=4,095, 92.6%), with free flaps used in 146 patients (3.3%) and mixed approaches in 180 (4.1%). Hernia-related pathology was the commonest indication (n=3751, 84.8%), followed by malignancy (n=470, 10.6%). Frequently used flap categories included anterolateral thigh, tensor fascia lata, rectus-based, and latissimus dorsi-based flaps. Flap selection was primarily defect-driven: fascia-bearing regional and turnover techniques were used mainly for structurally focused hernia repair, whereas composite flaps were used more often for oncologic, fistulating, traumatic, contaminated, or full-thickness defects. Common short-term complications include seroma, surgical site infection, and wound dehiscence. Flap failure and reported long term hernia recurrence were low. Free flaps were used more often for larger defects weighted mean 401 cm² vs 250 cm² for pedicled flaps), although size ranges overlapped.</p><p><strong>Conclusions: </strong>Autologous flap reconstruction is a durable and versatile option for selected complex abdominal wall defects. Reconstructive strategy should be guided primarily by defect composition.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411548","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":"Primary Grynfeltt hernia: multimodal imaging and laparoscopic transabdominal repair.","authors":"María Victoria Vieiro Medina, Pedro Antonio Pacheco, María Eugenia Torguet, Laura Alonso Murillo, Santos F Jiménez de Los Galanes","doi":"10.1007/s10029-026-03789-2","DOIUrl":"10.1007/s10029-026-03789-2","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411609","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":"Correction to: Retromuscular prophylactic mesh reinforcement after midline laparotomy: a systematic review and meta-analysis.","authors":"Melissa Lagger, Raffaella Sguinzi, Leo Buhler, Michel Adamina","doi":"10.1007/s10029-026-03791-8","DOIUrl":"10.1007/s10029-026-03791-8","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13350184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411618","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":"Psychological factors associated with chronic postoperative inguinal pain: a qualitative systematic review.","authors":"Guilherme de Carvalho Caldas, Maria Clara Morais, Clara Avelar Mendes de Vasconcellos, Pedro Henrique Silva de Oliveira Souza, Raquel Nogueira, Leandro Totti Cavazzola, Flavio Malcher, Diego Laurentino Lima","doi":"10.1007/s10029-026-03780-x","DOIUrl":"10.1007/s10029-026-03780-x","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic postoperative inguinal pain (CPIP) may affect up to 12% of patients undergoing inguinal hernia repair (IHR) and has surpassed recurrence as the most important patient-centered outcome of this procedure. Although psychological factors have been associated with chronic postsurgical pain, no consistent prognostic association has been established for CPIP, largely due to heterogeneity in psychometric instruments, outcome definitions, and assessment timing. This review aims to synthesize evidence and evaluate the methodological quality of studies on psychological factors associated with CPIP.</p><p><strong>Materials and methods: </strong>A systematic review was conducted in accordance with PRISMA guidelines, searching PubMed, EMBASE, and Web of Science. Studies of adults undergoing IHR that evaluated psychological factors in association with chronic pain development were included. Data extraction focused on baseline characteristics, protective and risk factors for CPIP, perioperative psychometric instruments, psychological constructs and domains, methodological heterogeneity across study designs and statistical models, and terminology consistency. The primary endpoint was to identify psychological factors associated with CPIP development across study populations.</p><p><strong>Results: </strong>Nine studies of 1,519 participants were identified. Among the studies that reported gender, 74 women were included (6.0%). In prospective studies, 78 patients (12.3%) developed CPIP. Eight psychometric instruments were identified; none was used in more than three studies. Anxiety was the most frequently assessed construct, present in 8 studies (88.9%), followed by depression in 6 (66.7%), pain catastrophizing and history of chronic pain each in 3 (33.3%), and optimism in 2 (22.2%). Significant associations between at least one psychological factor and chronic pain were reported in 5 studies (55.6%), of which 3 retained significances after multivariable adjustment (33.3%). Preoperative state anxiety independently predicted CPIP in two studies using the STAI. Dispositional optimism was the only protective factor identified in one study, while low optimism was associated with increased risk in the same study. CPIP definitions, assessment timing, and psychometric instruments varied substantially across studies.</p><p><strong>Conclusion: </strong>Preoperative state anxiety showed the most replicated association with CPIP, and dispositional optimism was identified as protective in one study. Substantial heterogeneity in psychometric assessment and highly variable perioperative factors restrict these findings to a hypothesis-generating role and highlight the need for methodological standardization in future CPIP research.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396654","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":"Comment to: Trisquel neoumbilicoplasty: three-flap spiral reconstruction in abdominal wall reconstruction patients.","authors":"Yanyan Huang","doi":"10.1007/s10029-026-03790-9","DOIUrl":"10.1007/s10029-026-03790-9","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396618","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":"Should occult contralateral inguinal hernias be repaired during unilateral TAPP? A systematic review and single-arm meta-analysis.","authors":"Maria Clara Morais, Denise Padilha Abs de Almeida, Thiago Souza E Silva, Raquel Nogueira, Diego Camacho, Leandro Totti Cavazzola, Flavio Malcher, Diego Laurentino Lima","doi":"10.1007/s10029-026-03773-w","DOIUrl":"10.1007/s10029-026-03773-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;Occult inguinal hernias (OIH) are frequently detected during laparoscopic repair of unilateral inguinal hernias due to direct visualization of the contralateral groin. However, the optimal management of these asymptomatic defects remains debated. This systematic review and single-arm meta-analysis aimed to evaluate the clinical characteristics and postoperative outcomes of contralateral OIH repaired during transabdominal preperitoneal (TAPP) repair.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review was conducted following PRISMA guidelines. PubMed, Embase, and Scopus were searched from inception to February 2026 for studies including adult patients undergoing TAPP repair with intraoperative identification of contralateral OIH. Due to heterogeneous reporting and inconsistent measures of dispersion, comparative meta-analysis was not feasible. A single-arm meta-analysis was therefore performed only on patients undergoing contralateral OIH repair. Data were synthesized with random-effects models for dichotomous outcomes. Continuous variables were pooled using inverse-variance methods. Weighted pooled estimates were calculated for baseline characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Five retrospective cohort studies published between 2018 and 2025 were included, comprising 4,485 total patients, of whom 873 (19.5%) had occult inguinal hernias identified intraoperatively and subsequently repaired. The majority of repairs were performed using laparoscopy, with robotic approach reported in two studies. Mean patient age was 52.6 ± 14.0 years, mean BMI was 23.4 ± 3.9 kg/m², and &gt; 90% of patients were male. Operative time ranged from 90.3 ± 30.9 to 132 ± 44.1 min, with a pooled mean of 116.9 min (95% CI 59.6-174.2) under a random-effects model (I² = 97.2%). Overall postoperative complications were reported in four studies, totaling 39 events among 819 patients (4.7%), with a pooled complication rate of 13% (95% CI 6-26%; I² = 31%). Surgical site infections (SSI) were rare, with 4 events among 873 patients (0.4%), corresponding to a pooled SSI rate of 1% (95% CI 1-2%; I² = 0%). Surgical site occurrences (SSO) were reported in 32 of 819 patients (3.6%), with a pooled rate of 12% (95% CI 4-29%; I² = 46.7%). Recurrence was reported in one study, with 9 cases (2.2%) during a mean follow-up of 30 months, and no reoperations or mortality were reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Occult inguinal hernias are identified in approximately one in five patients undergoing minimally invasive inguinal hernia repair. Repair of these defects during TAPP appears safe, with low surgical site infection rates, low complication rates, and no reported mortality or reoperation across available studies. Although contralateral repair may modestly increase operative time and short-term postoperative burden, it may reduce the likelihood of future symptomatic hernia development and the need for a second operation. Substantial heterogeneity and limi","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395906","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":"Glue versus absorbable tacks for mesh fixation in laparoscopic inguinal hernia repair: a systematic review and meta-analysis of postoperative pain and complications.","authors":"Caio Pluvier Duarte Costa, Ana Paula Valerio-Alves, Rachel Gomes Boechat de Oliveira, Thablu Matheus Alves Gonzaga, Ana Beatriz de Almeida Porto Maia, Zuila Rafaella Cavalcante de Oliveira, Rafael Morriello, Marcelo Henrique Ferreira Fernandes","doi":"10.1007/s10029-026-03757-w","DOIUrl":"10.1007/s10029-026-03757-w","url":null,"abstract":"<p><strong>Purpose: </strong>Mesh fixation is not routinely required in most laparoscopic inguinal hernia repairs (LIHR); however, when indicated, the optimal fixation method remains uncertain. This study aimed to compare surgical glue versus absorbable tacks (AT) for mesh fixation in LIHR, focusing on postoperative pain and early complications.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane for randomized controlled trials (RCTs) comparing glue versus AT in elective LIHR. Effect estimates were pooled using random-effects models and expressed as mean differences (MDs) or risk ratios (RRs) with 95% confidence intervals (CIs). The primary outcome was postoperative pain assessed by the visual analogue scale (VAS). Secondary outcomes included complications and operative time. Risk of bias was assessed using the Cochrane RoB 2 tool. Trial sequential analysis (TSA) and prediction intervals (PI) were used to assess robustness.</p><p><strong>Results: </strong>Nine RCTs comprising 1,289 patients were included. Glue fixation was associated with lower early postoperative pain at 7-14 days (MD - 0.77; 95% CI - 1.22 to - 0.33; p < 0.001; I² = 83%). However, substantial heterogeneity and wide prediction intervals (- 2.33 to 0.79) indicated variability across settings. TSA suggested evidence of potential effect; however, this finding should be interpreted in the context of substantial heterogeneity. No significant difference was observed beyond 4 weeks, with insufficient cumulative evidence to draw firm conclusions. Glue fixation was associated with lower rates of hematoma and seroma, although the findings were uncertain given the prediction intervals and TSA. Other outcomes were underpowered or inconclusive.</p><p><strong>Conclusion: </strong>Glue fixation may be associated with lower early postoperative pain than absorbable tacks after LIHR; however, the available evidence remains heterogeneous and inconclusive for other postoperative outcomes. Further adequately powered randomized trials are required before definitive clinical recommendations can be made.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375568","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":"Comment to: Comparison of polypropylene versus polyester mesh in Lichtenstein inguinal hernia repair with respect to chronic pain and inflammatory changes.","authors":"Çağrı Akalın","doi":"10.1007/s10029-026-03781-w","DOIUrl":"10.1007/s10029-026-03781-w","url":null,"abstract":"","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"30 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375641","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}