Prevalence of Obesity in Inguinal Hernia Repair Patients in a Tertiary Care Center

Abstract

Introduction: Inguinal hernia is a common surgical problem, with a lifetime risk of 27% in men and 3% in women. Its cumulative incidence is 17.2% and 12.3% in body mass index of <25 kg/m2 and 25–30 kg/m2 respectively. Obesity had been regarded as the risk factor for the development of an inguinal hernia. However, recent epidemiologic studies have suggested the decreased prevalence of inguinal hernia in increased weight and body mass index individuals. The aim of this study is to find out the prevalence of obesity in inguinal hernia repair patients in a tertiary care center.
 Methods: A descriptive cross-sectional observational study was performed in Bir Hospital from May 2018 to December 2019 after taking ethical approval from the institutional review board of NAMS. Convenient sampling was done with a sample size of 219. Statistical analysis was done using SPSS ver. 23 and Microsoft Excel software by descriptive statistics.
 Results: The mean body mass index was 22.10 ±3.07 kg/m2. Body mass index Category 18.5 – 22.9 kg/m2 had 133 (61%) male and seven (3.2%) female patients, category ≥30 kg/m2 had four (1.8%) male. Most of inguinal hernia repair patients were farmers 158 (72.5%). Common risk factors noted were smoking 142 (65.1%), heavy work 112 (51.4%), chronic cough 65 (29.8%). Most of the complications occurred in the normal body mass index category and the prevalence of complications decreased as the body mass index increased. The recurrence was found in 3 (1.4%) inguinal hernia repairs.
 Conclusions: The majority of inguinal hernia repair patients were non-obese, and complications were less in obese patients.

Sex-specific genetic variants associated with adult-onset inguinal hernia in a Taiwanese population

“…We also demonstrated that normal body mass index (BMI<24 kg/m 2 ) was inversely related to the formation of inguinal hernia, which has been reported in many previous studies. 39 - 41 While EFEMP1 locus has been associated with anthropometric measures of body height and abdominal circumference, shared genetic effects may explain the plausible causality between BMI and inguinal hernia, as previously noted by Hélène Choquet et al 20 However, further investigation of different pathophysiological associations of EFEMP1 in sex-specific manner may be considered as opposite correlations between EFEMP1 rs2009262 TC/CC and inguinal hernia were observed in different genders according to BMI levels.…”

A Comprehensive Review of Inguinal Hernia Occurrence in Obese Individuals

“…Multiple studies have shown that, however, an increased BMI actually involved a decreased risk of developing inguinal hernia. The occurrence of inguinal hernia was associated with normal rather than low or high values of the BMI (24)(25)(26)(27)(28)(29)(30)(31).…”

“…For example, some studies have shown that overweight and obese patients are more likely to develop recurrent hernias, hence the surgeons must be aware of their risk and these patients need a proper follow-up and a careful monitoring (28). However, other studies deny this correlation, stating that the outcomes of the surgery are not significantly different among obese patients: neither the recurrence risk, nor the complications increase with the BMI (29,24,33). Nonetheless, some difficulties, such as the increased risk of surgical site infections (24,34) or the increased operative time (30) might arise when performing surgery on obese patients.…”

Average Long-Term Outcomes of Laparoscopic Inguinal Hernia Repair

“…When determining the risk of developing the above complications, the main role is given to the quality of the surgical intervention, the strict adherence to the methodology of the surgical support both in open and laparoscopic operations [21,22]. At the same time, the role of common factors independent of the surgical technique is recognized, primarily the age of the patient and the concomitant pathological conditions, including obesity [23][24][25][26]. The question of the preference for one or another approach to hernioplasty, if available, doesn't appear to have been finally resolved in the meantime.…”