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Erschienen in: Surgical Endoscopy 5/2020

15.07.2019

No difference in genitourinary complications after laparoscopic vs. open groin hernia repair in women: a nationwide linked register-based cohort study

verfasst von: Line Schmidt, Kristoffer Andresen, Jacob Rosenberg

Erschienen in: Surgical Endoscopy | Ausgabe 5/2020

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Abstract

Background

During laparoscopic groin hernia repair, the surgeon may transect the round ligament of uterus to facilitate mesh placement. Transection during open repair is rarer and anatomically further from the uterus. Our aim was to compare long-term genitourinary outcomes, particularly genital prolapse, between open and laparoscopic repair in women with a primary groin hernia.

Methods

The study was reported according to RECORD guidelines. All women having received a primary anterior open or laparoscopic groin hernia repair from 1998 to 2014 were identified through The Danish Hernia Database and linked with data from The Danish National Patient Registry and the Danish Register of Causes of Death. Our outcome was postoperative genital prolapse and other long-term complications related to gynecology, urology, and infertility.

Results

We included 10,867 women having received a primary groin hernia repair, 7732 (71%) had an open anterior repair and 3135 (29%) a laparoscopic repair. The median (range) age was 59 (19–102) and 64 (18–105), respectively (p < 0.001). Median follow-up was 65 (range 0–203) months. After open repair, 313/7340 (4.2%) had a postoperative genital prolapse, and 46/2,934 (1.5%) after laparoscopic repair (p < 0.001). In multivariate Cox Regression analyses adjusting for age and hernia type, there were no difference between the two methods (p = 0.474). Women with an inguinal hernia had a higher risk of genital prolapse than women with a femoral hernia, independent of repair method [HR = 1.455 (1.143–1.853), p = 0.002]. We found no significant differences between open and laparoscopic methods in multivariate analyses assessing other long-term postoperative genitourinary and/or infertility outcomes.

Conclusion

We found no differences in postoperative genital prolapse or other complications related to gynecology, urology, and/or infertility between open anterior and laparoscopic groin hernia repair in women. Assuming the round ligament of uterus is being transected more often in laparoscopic repair than in open, the urogenital consequences of transection seem to be minimal.
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Literatur
1.
Zurück zum Zitat Burcharth J, Pedersen M, Bisgaard T, Pedersen C, Rosenberg J (2013) Nationwide prevalence of groin hernia repair. PLoS ONE 8:e54367CrossRef Burcharth J, Pedersen M, Bisgaard T, Pedersen C, Rosenberg J (2013) Nationwide prevalence of groin hernia repair. PLoS ONE 8:e54367CrossRef
2.
Zurück zum Zitat Weber A, Valencia S, Garteiz D, Burguess A (2001) Epidemology of Hernias in the Female. In: Bendavid R, Abrahamson J, Arregui ME, Flament JB, Phillips EH (eds) Abdominal Wall Hernias: principles and management. Springer, New York, pp 613–619CrossRef Weber A, Valencia S, Garteiz D, Burguess A (2001) Epidemology of Hernias in the Female. In: Bendavid R, Abrahamson J, Arregui ME, Flament JB, Phillips EH (eds) Abdominal Wall Hernias: principles and management. Springer, New York, pp 613–619CrossRef
3.
4.
Zurück zum Zitat The HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef The HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef
5.
Zurück zum Zitat Nilsson H, Holmberg H, Nordin P (2017) Groin hernia repair in women—a nationwide register study. Am J Surg 216:274–279CrossRef Nilsson H, Holmberg H, Nordin P (2017) Groin hernia repair in women—a nationwide register study. Am J Surg 216:274–279CrossRef
6.
Zurück zum Zitat Schmidt L, Oberg S, Andresen K, Rosenberg J (2018) Laparoscopic repair is superior to open techniques when treating primary groin hernias in women: a nationwide register-based cohort study. Surg Endosc 33:71–78CrossRef Schmidt L, Oberg S, Andresen K, Rosenberg J (2018) Laparoscopic repair is superior to open techniques when treating primary groin hernias in women: a nationwide register-based cohort study. Surg Endosc 33:71–78CrossRef
7.
Zurück zum Zitat Schmidt L, Öberg S, Andresen K, Rosenberg J (2018) Recurrence rates after inguinal hernia repair in women: a systematic review. JAMA Surg 153:1135–1142CrossRef Schmidt L, Öberg S, Andresen K, Rosenberg J (2018) Recurrence rates after inguinal hernia repair in women: a systematic review. JAMA Surg 153:1135–1142CrossRef
8.
Zurück zum Zitat Cobb WS (2013) Technique: Laparoscopic TAPP and IPOM. In: Jacob BP, Ramshaw B (eds) The SAGES manual of Hernia repair. Springer, New York, pp 81–89CrossRef Cobb WS (2013) Technique: Laparoscopic TAPP and IPOM. In: Jacob BP, Ramshaw B (eds) The SAGES manual of Hernia repair. Springer, New York, pp 81–89CrossRef
9.
Zurück zum Zitat Yang XF, Liu JL (2016) Laparoscopic repair of inguinal hernia in adults. Ann Transl Med 4:402CrossRef Yang XF, Liu JL (2016) Laparoscopic repair of inguinal hernia in adults. Ann Transl Med 4:402CrossRef
10.
Zurück zum Zitat Ando H, Kaneko K, Ito F, Seo T, Ito T (1997) Anatomy of the round ligament in female infants and children with an inguinal hernia. Br J Surg 84:404–405CrossRef Ando H, Kaneko K, Ito F, Seo T, Ito T (1997) Anatomy of the round ligament in female infants and children with an inguinal hernia. Br J Surg 84:404–405CrossRef
11.
Zurück zum Zitat Drake R, Vogl W, Mitchell AWM (2015) Pelvis and perineum. In: Drake R, Vogl W, Mitchell AWM (eds) Gray’s anatomy for students, 3rd edn. Churchill Livingstone, London, pp 421–432 Drake R, Vogl W, Mitchell AWM (2015) Pelvis and perineum. In: Drake R, Vogl W, Mitchell AWM (eds) Gray’s anatomy for students, 3rd edn. Churchill Livingstone, London, pp 421–432
12.
Zurück zum Zitat Mahran M, Ghaleb HA (1964) The physiology of the human round ligament. J Obstet Gynaecol Br Commonw 71:374–378CrossRef Mahran M, Ghaleb HA (1964) The physiology of the human round ligament. J Obstet Gynaecol Br Commonw 71:374–378CrossRef
13.
Zurück zum Zitat Yen CF, Wang CJ, Lin SL, Lee CL, Soong YK (2002) Combined laparoscopic uterosacral and round ligament procedures for treatment of symptomatic uterine retroversion and mild uterine decensus. J Am Assoc Gynecol Laparosc 9:359–366CrossRef Yen CF, Wang CJ, Lin SL, Lee CL, Soong YK (2002) Combined laparoscopic uterosacral and round ligament procedures for treatment of symptomatic uterine retroversion and mild uterine decensus. J Am Assoc Gynecol Laparosc 9:359–366CrossRef
14.
Zurück zum Zitat Schmidt L, Andresen K, Oberg S, Rosenberg J (2018) Dealing with the round ligament of uterus in laparoscopic groin hernia repair: a nationwide survey among experienced surgeons. Hernia 22:849–855CrossRef Schmidt L, Andresen K, Oberg S, Rosenberg J (2018) Dealing with the round ligament of uterus in laparoscopic groin hernia repair: a nationwide survey among experienced surgeons. Hernia 22:849–855CrossRef
15.
Zurück zum Zitat Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, Sorensen HT, von Elm E, Langan SM (2015) The reporting of studies conducted using observational routinely-collected health data (RECORD) statement. PLoS Med 12:e1001885CrossRef Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, Sorensen HT, von Elm E, Langan SM (2015) The reporting of studies conducted using observational routinely-collected health data (RECORD) statement. PLoS Med 12:e1001885CrossRef
16.
Zurück zum Zitat Friis-Andersen H, Bisgaard T (2016) The Danish inguinal hernia database. Clin Epidemiol 8:521–524CrossRef Friis-Andersen H, Bisgaard T (2016) The Danish inguinal hernia database. Clin Epidemiol 8:521–524CrossRef
17.
Zurück zum Zitat Schmidt M, Schmidt SA, Sandegaard JL, Ehrenstein V, Pedersen L, Sorensen HT (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 7:449–490CrossRef Schmidt M, Schmidt SA, Sandegaard JL, Ehrenstein V, Pedersen L, Sorensen HT (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 7:449–490CrossRef
18.
Zurück zum Zitat Helweg-Larsen K (2011) The Danish register of causes of death. Scand J Public Health 39:26–29CrossRef Helweg-Larsen K (2011) The Danish register of causes of death. Scand J Public Health 39:26–29CrossRef
19.
Zurück zum Zitat Kyle-Leinhase I, Kockerling F, Jorgensen LN, Montgomery A, Gillion JF, Rodriguez JAP, Hope W, Muysoms F (2018) Comparison of hernia registries: the CORE project. Hernia 22:561–575CrossRef Kyle-Leinhase I, Kockerling F, Jorgensen LN, Montgomery A, Gillion JF, Rodriguez JAP, Hope W, Muysoms F (2018) Comparison of hernia registries: the CORE project. Hernia 22:561–575CrossRef
22.
Zurück zum Zitat Pedersen CB, Gotzsche H, Moller JO, Mortensen PB (2006) The Danish civil registration system. A cohort of eight million persons. Dan Med Bull 53:441–449PubMed Pedersen CB, Gotzsche H, Moller JO, Mortensen PB (2006) The Danish civil registration system. A cohort of eight million persons. Dan Med Bull 53:441–449PubMed
23.
Zurück zum Zitat Vergelt TF, Weemhoff M, Inthout J, Kluivers KB (2015) Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J 26:1559–1573CrossRef Vergelt TF, Weemhoff M, Inthout J, Kluivers KB (2015) Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J 26:1559–1573CrossRef
Metadaten
Titel
No difference in genitourinary complications after laparoscopic vs. open groin hernia repair in women: a nationwide linked register-based cohort study
verfasst von
Line Schmidt
Kristoffer Andresen
Jacob Rosenberg
Publikationsdatum
15.07.2019
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 5/2020
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-06973-x

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