Factors associated with postoperative complications and hernia recurrence for patients undergoing inguinal hernia repair: a report from the VA Cooperative Hernia Study Group

Matthews, Richard D.; Anthony, Thomas; Kim, Lawrence T.; Wang, Jia; Fitzgibbons, Robert J.; Giobbie-Hurder, Anita; Reda, Domenic J.; Itani, Kamal M.F.; Neumayer, Leigh A.; Veterans Affairs Cooperative 456 Studies Program Investigators,

doi:10.1016/j.amjsurg.2007.07.018

« Previous Next »The American Journal of Surgery
Volume 194, Issue 5 , Pages 611-617, November 2007

Factors associated with postoperative complications and hernia recurrence for patients undergoing inguinal hernia repair: a report from the VA Cooperative Hernia Study Group

Presented at the 31st Annual Surgical Symposium of the Association of VA Surgeons, Little Rock, AR, May 10–12, 2007

Richard D. Matthews, M.D.
- George E. Wahlen Salt Lake City VA Health Care System and University of Utah Department of Surgery, VAMC-112, 500 Foothill Dr, Salt Lake City, UT 84148, USA
Thomas Anthony, M.D.
- VA North Texas Health Care System and University of Texas Southwestern Medical School, 4500 S. Lancaster Rd, Dallas, TX 75216, USA
Lawrence T. Kim, M.D.
- Central Arkansas VA Healthcare System and University of Arkansas for Medical Sciences, 4300 W. 7th St, Little Rock, AR 72205, USA
Jia Wang, M.S.
- VA Cooperative Studies Program Coordinating Center, 5th & Roosevelt Rd, Hines, IL 60141, USA
Robert J. Fitzgibbons Jr, M.D.
- VA Nebraska Western Iowa Health Care System and Creighton University, 4101 Woolworth Ave, Omaha, NE 68105, USA
Anita Giobbie-Hurder, M.S.
- VA Cooperative Studies Program Coordinating Center, 5th & Roosevelt Rd, Hines, IL 60141, USA
Domenic J. Reda, Ph.D.
- VA Cooperative Studies Program Coordinating Center, 5th & Roosevelt Rd, Hines, IL 60141, USA
Kamal M.F. Itani, M.D.
- VA Boston Health Care System and Boston University, 150 S. Huntington Ave, Boston, MA 02130, USA
Leigh A. Neumayer, M.D.
- George E. Wahlen Salt Lake City VA Health Care System and University of Utah Department of Surgery, VAMC-112, 500 Foothill Dr, Salt Lake City, UT 84148, USA
- Corresponding author. Tel.: +1-801-581-2431; fax: +1-801-585-2425.
Veterans Affairs Cooperative 456 Studies Program Investigators

Received 25 May 2007; received in revised form 29 July 2007

Abstract

Background

We sought to determine perioperative variables predictive of complications or recurrence for patients undergoing surgical repair of inguinal hernias.

Patients and Methods

Using data from the Veterans Affairs trial, regression analyses were utilized to identify perioperative factors significantly associated with complications (overall, short-term and long-term), long-term pain, and to develop a risk model for recurrence.

Results

Recurrent and scrotal hernias were predictors for short term and overall complications, regardless of technique. Older age and higher Mental Component Score of the SF-36 were associated with higher risk of long term complications in the open group while prostatism and increased body mass index were the significant predictors in the laparoscopic group. Long-term pain complaints decreased as patient age increased in both groups. Patient and surgeon factors were predictive of recurrence but varied greatly depending on surgical technique.

Conclusions

Regardless of technique, scrotal and recurrent hernias were associated with a greater risk of complications and younger patients had more long-term pain. Predictors of recurrence vary based on surgical technique.

Keywords: Complications, Recurrence, Inguinal, Herniorrhaphy, Lichtenstein, Laparoscopic