title: Direct and recurrent inguinal hernias are associated with ventral hernia repair: a database study.
abstract: BACKGROUND
  A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery.
  
  
  METHODS
  In the nationwide Danish Hernia Database, a cohort of 92,457 patients operated on for inguinal hernias was recorded from January 1998 until June 2010. Eight-hundred forty-three (0.91 %) of these patients underwent a ventral hernia operation between January 2007 and June 2010. A multivariate logistic regression analysis was applied to assess an association between inguinal and ventral hernia repair.
  
  
  RESULTS
  Direct (Odds Ratio [OR] = 1.28 [95 % CI, 1.08-1.51]) and recurrent (OR = 1.76, [95 % CI, 1.39-2.23]) inguinal hernias were significantly associated with ventral hernia repair after adjustment for age, gender, and surgical approach (open or laparoscopic).
  
  
  CONCLUSIONS
  Patients with direct and recurrent inguinal herniation are more prone to ventral hernia repair than patients with indirect inguinal herniation. This is the first study to show that herniogenesis is associated with type of inguinal hernia.
authors.affiliation: Department of Surgery K, University of Copenhagen, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. nadiahenriksen@gmail.com
authors.forename: Nadia A
authors.initials: NA
authors.lastname: Henriksen
authors.forename: Lars T
authors.initials: LT
authors.lastname: Sorensen
authors.forename: Morten
authors.initials: M
authors.lastname: Bay-Nielsen
authors.forename: Lars N
authors.initials: LN
authors.lastname: Jorgensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D003718:Denmark; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications* / Q000601:surgery; D006555:Hernia, Ventral / Q000209:etiology* / Q000601:surgery; D059685:Herniorrhaphy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012307:Risk Factors; D055815:Young Adult