title: Second hernia repairs in children-a nationwide study.
abstract: BACKGROUND
  Second inguinal hernia repairs may be needed either owing to contralateral metachronous hernia (MH) or ipsilateral recurrent hernia (RH). In this study, we estimated the incidence rates of MH and RH from a large nationwide database.
  
  
  METHODS
  The information was obtained from the National Health Insurance Database (with 23 million insurants). Subjects with hernia repairs were identified, and information such as age, gender, unilateral/bilateral procedures in the first and second hernia repairs were analyzed.
  
  
  RESULTS
  Among the 92,308 newborns observed from their births to the end of 6th year, 3881 had first hernia repairs. Among the 3068 subjects with first unilateral repairs, 307 had second repairs, and among the 813 with first bilateral repairs, 15 had second repairs. The incidence of second repairs was 10.85% (13.71% if <1year old) after first unilateral repairs and was 1.23% (0.63% if <1year old) after first bilateral repairs.
  
  
  CONCLUSIONS
  The incidence of RH (estimated from second hernia repairs after first bilateral repairs) was 1.23%. The incidence of MH (from second repairs after first unilateral repairs) was 9.62%. These incidence rates are consistent with other published reports.
authors.affiliation: Pediatric Surgery, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: twchin@vghtpe.gov.tw.
authors.forename: Tai-Wai
authors.initials: TW
authors.lastname: Chin
authors.affiliation: Institute of Information Science, Academia Sinica, Taipei, Taiwan.
authors.forename: Mei-Lien
authors.initials: ML
authors.lastname: Pan
authors.affiliation: Experimental Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Pediatric Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Hsin-Lin
authors.initials: HL
authors.lastname: Tsai
authors.affiliation: Pediatric Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Chin-Su
authors.initials: CS
authors.lastname: Liu
mesh_terms: D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D013624:Taiwan / Q000453:epidemiology
keywords: Inguinal hernia; Metachronous hernia; Recurrent hernia