title: Hernia surgery changes in the Amsterdam region 1994-2001: decrease in operations for recurrent hernia.
abstract: Inguinal hernia (IH) surgery has changed substantially in the past decade. Conventional (nonmesh) techniques have largely given way to prostheses. This study's aim was to analyse whether changes in technique used for IH repair influenced the operation rate for recurrence. A retrospective study was performed on all adult males who had undergone IH surgery in the Amsterdam region during the calendar years of 1994, 1996, 1999, and 2001. Data were obtained for 3,649 subjects and included patient demographics, hernia type, and surgical technique. We observed a decrease in the use of conventional techniques and a significant increase (P<0.05) in the use of prosthetic materials. The number of operations performed for recurrent hernia decreased from 19.5% (216/1,108) in 1994, to 16.8% 197/1,170) in 1996, to 14.0% (152/1,088) in 1999, and to 14.1% (40/283) in 2001. When comparing 1999 and 2001 with 1994, there was a significant decrease in operations performed for recurrent hernia (P=0.005). There was also a significant increase in supervision of the surgical resident by a surgeon.
authors.affiliation: Department of Surgery, Onze Lieve Vrouwe Gasthuis, P.O. Box 95500, 1090 HM, Amsterdam, The Netherlands.
authors.forename: T J
authors.initials: TJ
authors.lastname: Aufenacker
authors.forename: D H
authors.initials: DH
authors.lastname: de Lange
authors.forename: M D
authors.initials: MD
authors.lastname: Burg
authors.forename: B W
authors.initials: BW
authors.lastname: Kuiken
authors.forename: E F
authors.initials: EF
authors.lastname: Hensen
authors.forename: I G
authors.initials: IG
authors.lastname: Schoots
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: M P
authors.initials: MP
authors.lastname: Simons
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002983:Clinical Competence / Q000592:standards; D013502:General Surgery / Q000193:education / Q000592:standards; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000639:trends; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends; D013536:Suture Techniques / Q000706:statistics & numerical data