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 21 February 2018

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News

Danish researchers conduct quality assessment of 26,304 herniorrhaphies

There is a large potential for cost savings and more efficient patient care in groin hernia surgery, with extended use of mesh techniques, outpatient surgery, and local anesthesia, according to research in this week's Lancet.

News image

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A group of researchers from Hvidovre, Denmark, investigated the outcome results of groin hernia surgery, to improve the quality of treatment.

They prospectively recorded 26,304 groin hernia repairs, done in Denmark between 1998 and 2000, in a nationwide Danish hernia database.

Some 93% of all groin herniorrhaphies done in Denmark, in the 30 months of the study, were recorded in the database.

Kaplan-Meier estimates of reoperation rates, 30 months after the operations, were made. The rates for anterior mesh repair and laparoscopic repair were significantly lower than after sutured posterior wall repairs in primary inguinal hernia (2·2% and 2·6%, vs 4·4%).

Reoperation rates were also lower with anterior mesh repair (6·1%) and laparoscopic repair (3·4%), than with sutured posterior wall repair (10·6%) after recurrent hernia.

Reoperation rates lower after anterior mesh and laparoscopic repair.
Lancet

Use of Lichtenstein mesh repair increased from 33% in January 1998, to 62% in June 2000. However, use of laparoscopic repair remained constant at about 5%.

Kaplan-Meier estimates of reoperation rates were 2·8% in the first 15 months and 1·6% in the second.

For elective repairs, only 59% of patients were treated on an outpatient basis, and only 18% had local anesthesia.

Dr Morten Bay-Nielsen, of Hvidovre University Hospital, said on behalf of fellow authors, "Mesh repairs have a lower reoperation rate than conventional open repairs."

"Systematic prospective recording of treatment and outcome variables in a national clinical database improved the overall quality of surgical care.

"However, there is a large potential for cost savings and more efficient patient care with extended use of mesh techniques, outpatient surgery, and local anesthesia," it was concluded.

Lancet 2001; 358: 1124-8
09 October 2001

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