The incidence of recurrence after inguinal hernia repair: A single-center experience

Importance: Despite the improvement of treatment modalities and technical aspects, recurrence following hernia repair remains one of the main problems for the surgical community. More specifically, previous Cochrane Systematic Review and large database studies compared Lichtenstein repairs. However, none of the relevant published reports were representative of the Saudi population. Objective: This study's objective was to investigate the overall and gender-specific prevalence of recurrences in patients who had undergone Lichtenstein mesh repair of primary inguinal hernia (IH) in the KFHU Centre. Design: This is a retrospective record review study conducted between January 2000 and December 2014. Setting: The study was conducted at a single center located in Saudi Arabia, at King Fahed Hospital University KFHU center. Participants: Adults (≥18 years of age), with IH, operated at KFHU using standard Lichtenstein open mesh repair, and had minimum follow-up of 2 years were included in the study. Laparoscopically operated cases, recurrent and emergently operated cases were excluded from the study. Main Outcome (s) and Measure (s): Data were collected by records review and included sociodemographic characteristics (age, gender, and family history), hernia type and location, risk factors (body mass index [BMI], smoking, comorbidities, etc.), recurrence and other complications (pain, wound hematoma and seroma, infection, etc.). Results: We report a recurrence rate of 1.3% following Liechtenstein mesh repair at our center. As for patient-related factors that were found to be significantly associated with the recurrence of an IH were older age, higher BMI, the existence of hypertension, chronic cough and diabetes, in addition to smoking and lifting heavy objects. Conclusion: We have identified several likely factors associated with higher recurrence after hernia repair. A comparison of the rates of recurrence and complications between different procedures should, therefore, be an important topic to address in future studies.