Objective
To determine age- and sex-specific incidence rates of inguinal hernia repairs (IHR) in a well defined USA population and examine trends over time.
Summary Background Data
IHR represent a substantial burden to the US healthcare system. An up to date appraisal will identify future healthcare needs.
Methods
A retrospective review of all IHR performed on adult residents of Olmsted County, MN from 1989 to 2008 was performed. Cases were ascertained through the Rochester Epidemiology Project, a record-linkage system with >97% population coverage. Incidence rates were calculated by using incident cases as the numerator and population counts from the census as the denominator. Trends over time were evaluated using Poisson regression.
Results
During the study period, a total of 4,026 IHR were performed on 3,599 unique adults. Incidence rates per 100,000 person-years were greater for men: 368 vs 44 for women, and increased with age: from 194 to 648 in men, and from 28 to 108 in women between 30 and 70 years of age. Initial, unilateral IHR comprised 74% of all IHR types. The life-long cumulative incidence of an initial, unilateral or bilateral IHR in adulthood was 42.5% in men and 5.8% in women. Over time (from 1989 to 2008), the incidence of initial, unilateral IHR in men decreased from 474 to 373 (relative reduction, RR=21%). Bilateral IHR increased from 42 to 71 (relative increase=70%), contralateral metachronous IHR decreased from 29 to 11 (RR=62%), and recurrent IHR decreased from 66 to 26 (RR=61%), all changes p<0.001.
Conclusions
IHR are common, their incidence varies greatly by age and sex, and has decreased substantially over time in Olmsted County, Minnesota.
Several risk factors are associated with revision adenoidectomy: young age at initial procedure, indication for adenoidectomy, and diagnosis of gastroesophageal reflux disease. Surgical technique, level of experience of the initial surgeon, and diagnosis of asthma or allergies were not significant risk factors for revision adenoidectomy.
Background
The use of inguinal hernia repair techniques in the community setting is poorly understood.
Methods
A retrospective review of all inguinal hernia repairs performed on adult residents of Olmsted County, MN, from 1989 to 2008 was performed through the Rochester Epidemiology Project.
Results
A total of 4,433 inguinal hernia repairs among 3,489 individuals were reviewed. Non–mesh-based repairs predominated in the late 1980s (94% in 1989), declined throughout the 1990s (40% in 1996), and are rarely used nowadays (4% in 2008). Open mesh-based repairs comprised 21% in 1990, peaked in 2001 with 72%, and declined to 55% in 2008. The adoption of laparoscopic repairs began in 1992 (6%) and has increased steadily to 41% in 2008 (P < .001).
Conclusions
Although non–mesh-based repairs, once the predominant method, have been supplanted by open mesh-based techniques, nowadays the use of laparoscopic inguinal hernia repair techniques has increased substantially to nearly equal that of open mesh-based techniques.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.