Mikhail Attaar, Beau Forester, Kristine Kuchta, Michael B Ujiki, John Linn, Woody Denham, H Mason Hedberg, Stephen Haggerty
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Differences between obese and non-obese patients were assessed using independent samples t-tests, Wilcoxon rank-sum, and chi-square tests.</p><p><strong>Results: </strong>Between 2010 and 2021, a total of 5575 patients underwent inguinal hernia repair. Fifteen percent of patients were identified as obese (835 patients, mean BMI 33.2 ± 3.3 kg/m<sup>2</sup>). A significantly higher percentage of obese patients were diabetic, and operative time and estimated blood loss were higher in the obese group (all p < 0.001). Rates of hernia recurrence in obese patients was significantly more likely than in non-obese patients (4.2% vs 2.0%, p < 0.001). Up to 2 years postoperatively, a greater percentage of obese patients reported worse quality of life on the SOMS and more bothersome symptoms on the CCS.</p><p><strong>Conclusions: </strong>Inguinal hernia repair in obese patients is a more technically challenging operation. Long-term follow-up revealed a greater risk of hernia recurrence and worse quality of life up to 2 years postoperatively in this patient population.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Higher rates of recurrence and worse quality of life in obese patients undergoing inguinal hernia repair.\",\"authors\":\"Mikhail Attaar, Beau Forester, Kristine Kuchta, Michael B Ujiki, John Linn, Woody Denham, H Mason Hedberg, Stephen Haggerty\",\"doi\":\"10.1007/s10029-024-03154-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Prior investigations regarding the effect of obesity on inguinal hernia repair have been mixed. 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A significantly higher percentage of obese patients were diabetic, and operative time and estimated blood loss were higher in the obese group (all p < 0.001). Rates of hernia recurrence in obese patients was significantly more likely than in non-obese patients (4.2% vs 2.0%, p < 0.001). Up to 2 years postoperatively, a greater percentage of obese patients reported worse quality of life on the SOMS and more bothersome symptoms on the CCS.</p><p><strong>Conclusions: </strong>Inguinal hernia repair in obese patients is a more technically challenging operation. 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引用次数: 0
摘要
目的：此前有关肥胖对腹股沟疝修补术影响的研究结果不一。我们的研究旨在回顾性比较接受腹股沟疝修补术的肥胖和非肥胖患者的围手术期结果、复发率和生活质量：方法：从前瞻性维护的质量数据库中筛选出在一家医疗机构接受腹股沟疝修补术的患者。体重指数（BMI）大于或等于 30 kg/m2 的患者被视为肥胖。生活质量通过手术结果测量系统（SOMS）和卡罗莱纳舒适度量表（CSS）调查进行测量。采用独立样本 t 检验、Wilcoxon 秩和检验和卡方检验评估肥胖与非肥胖患者之间的差异：2010年至2021年间，共有5575名患者接受了腹股沟疝修补术。15%的患者被确认为肥胖（835名患者，平均体重指数（BMI）为33.2 ± 3.3 kg/m2）。肥胖患者中糖尿病患者的比例明显更高，肥胖组患者的手术时间和估计失血量也更高：肥胖患者的腹股沟疝修补术在技术上更具挑战性。长期随访显示，这类患者术后两年内疝气复发的风险更高，生活质量更差。
Higher rates of recurrence and worse quality of life in obese patients undergoing inguinal hernia repair.
Purpose: Prior investigations regarding the effect of obesity on inguinal hernia repair have been mixed. The aim of our study was to retrospectively compare perioperative outcomes, recurrence rate, and quality of life between obese and non-obese patients undergoing inguinal hernia repair.
Methods: Patients who underwent inguinal hernia repair by any approach at a single institution were identified from a prospectively maintained quality database. Patients with a body mass index (BMI) greater than or equal to 30 kg/m2 were considered obese. Quality of life was measured with the Surgical Outcomes Measurement System (SOMS) and Carolinas Comfort Scale (CSS) surveys. Differences between obese and non-obese patients were assessed using independent samples t-tests, Wilcoxon rank-sum, and chi-square tests.
Results: Between 2010 and 2021, a total of 5575 patients underwent inguinal hernia repair. Fifteen percent of patients were identified as obese (835 patients, mean BMI 33.2 ± 3.3 kg/m2). A significantly higher percentage of obese patients were diabetic, and operative time and estimated blood loss were higher in the obese group (all p < 0.001). Rates of hernia recurrence in obese patients was significantly more likely than in non-obese patients (4.2% vs 2.0%, p < 0.001). Up to 2 years postoperatively, a greater percentage of obese patients reported worse quality of life on the SOMS and more bothersome symptoms on the CCS.
Conclusions: Inguinal hernia repair in obese patients is a more technically challenging operation. Long-term follow-up revealed a greater risk of hernia recurrence and worse quality of life up to 2 years postoperatively in this patient population.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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