Reoperation after recurrent groin hernia repair

Objective To analyze reoperation rates for recurrent and primary groin hernia repair documented in the Swedish Hernia Register from 1996 to 1998, and to study v ariables associated with increased or decreased relative risks for reoperat ion after recurrent hernia. Methods Data were retrieved for all groin hernia repairs prospectively recorded in the Swedish Hernia register from 1996 to 1998, Actuarial analysis adjusted for patients' death was used for calculating the cumulative incidence of re operation. Relative risk for reoperation was estimated using the Cox propor tional hazards model. Results From 1998 to 1998, 17,985 groin hernia operations were recorded in the Swed ish Hernia Register, 15% for recurrent hernia and 85% for primary hernia. A t 24 months the risk for having had a reoperation was 4.6% after recurrent hernia repair and 1.7% after primary hernia repair. The relative risk for r eoperation was significantly lower for laparoscopic methods and for anterio r tension-free repair than for other techniques. Postoperative complication s and direct hernia were associated with an increased relative risk for reo peration. Day-case surgery and local infiltration anesthesia were used less frequently for recurrent hernia than for primary hernia. Conclusions Recurrent groin hernia still constitutes a significant quantitative problem for the surgical community. This study supports the use of mesh by laparos copy or anterior tension-free repair for recurrent hernia operations.