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- Nordin, Pär, et al.
(author)
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Choice of anesthesia and risk of reooperation for recurrence in groin hernia repair
- 2004
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In: Annals of Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 0003-4932 .- 1528-1140. ; 240:1, s. 187-192
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Journal article (peer-reviewed)abstract
- Objective: To analyze the relative risk of reoperation for recurrence using 3 anesthetic alternatives, general anesthesia (GA), regional (spinal-, epidural-) anesthesia (RA), and local anesthesia (LA), and to study time trends for various anesthetic and operative methods, as well as other risk factors regarding reoperation for recurrence.Background: The method of anesthesia used for hernia repair is generally assumed not to affect the long-term outcome. The few studies on the topic have rendered conflicting results.Methods: Data from the Swedish Hernia Register was used. Relative risk was first estimated using univariate analysis for assumed risk variables and then selecting variables with the highest or lowest univariate risk for multivariate analysis.Results: From 1992 through 2001, 59,823 hernia repairs were recorded. Despite the fact that univariate analysis showed a somewhat lower risk for reoperation in the LA group, the multivariate analysis showed that LA was associated with a significantly increased risk for reoperation in primary but not in recurrent hernia repair. The Lichtenstein technique carried a significantly lower reoperation risk than any other method of operation.Conclusions: LA was associated with a higher risk of reoperation for recurrence after primary hernia repair. The use of mesh techniques has increased considerably, and among these the Lichtenstein repair was associated with a significantly lower risk for reoperation than any other repair.
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- Nordin, P, et al.
(author)
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Influence of suture material and surgical technique on risk of reoperation after non-mesh open hernia repair
- 2003
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In: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 90:8, s. 1004-1008
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Journal article (peer-reviewed)abstract
- Background: Although mesh techniques are used with increasing frequency, sutured repair still has a place in groin hernia surgery. Studies relating suture material to recurrence rate have yielded conflicting results. The aim of the present study was to analyse the influence of suture material and sutured non-mesh technique on the risk of reoperation in open groin hernia repair using data from the Swedish Hernia Register. Methods: The relative risk of reoperation after sutured repair using non-absorbable, late absorbable and early absorbable sutures was compared in multivariate analyses, taking into account known confounding factors. Results: Between 1992 and 2000, 46 745 hernia repairs were recorded in the Swedish Hernia Register. Of these, 18 057 repairs were performed with open non-mesh methods and were included in the analysis. Using non-absorbable suture as reference, the relative risk of reoperation after repair with early absorbable suture and late absorbable suture was 1.50 (95 per cent confidence interval (c.i.) 1.22 to 1.83) and 1.03 (95 per cent c.i. 0.83 to 1.28) respectively. Using the Shouldice repair as reference, other sutured repairs were associated with a significantly higher relative risk of reoperation (1.22, 95 per cent c.i. 1.03 to 1.44). Conclusion: A non-absorbable or a late absorbable suture is recommended for open non-mesh groin hernia repair. The Shouldice technique was found to be superior to other open methods.
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