title: Low complication rate and an increasing incidence of surgical repair of primary indirect sliding inguinal hernia.
abstract: OBJECTIVE
  The purpose of the present study was to explore the risk for complications and reoperations following open repairs for sliding groin hernias.
  
  
  METHODS
  All primary indirect inguinal hernia repairs registered in the Swedish Hernia Register 1998-2011 were identified. Repeated and bilateral procedures were excluded. The epidemiology, the incidence of per- and postoperative complications, and the reoperation rate due to recurrences were analyzed.
  
  
  RESULTS
  100 240 non-repeated unilateral repairs were registered with sliding hernias in 13 132 (13.1 %) (male 14 %, female 5 %) procedures. The methods of repair for sliding and non-sliding hernias were Lichtenstein and other open anterior mesh repairs (N = 10865, 82.7 % and N = 60790, 69.8 %), endoscopic techniques (N = 136, 1.0 % and N = 4352, 5.0 %), and other techniques (N = 2131, 16.2 % and N = 21966, 25.2 %). In multivariate analyses with adjustment for gender, acute/planned surgery, reducibility, method of repair and age, sliding hernias were associated with a low but slightly increased risk for perioperative complications (hazard ratio 1.30, 95 % confidence interval 1.04-1.62, p = 0.023) and postoperative hematoma (hazard ratio 1.13, confidence interval 1.02-1.26, p = 0.019). There was no increased risk of reoperation due to recurrences.
  
  
  CONCLUSIONS
  Compared to older reports, the incidence of repairs due to primary indirect sliding inguinal hernias has increased over time and it is not just a male disease. The overall results are good with low and comparable complication rates, and no increased risk of reoperations due to recurrences.
authors.affiliation: Department of Surgery, Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85, Lund, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Hallén
authors.affiliation: Department of Surgery, Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85, Lund, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Sevonius
authors.affiliation: Epidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Holmberg
authors.affiliation: CLINTEC, Division of Surgery, Karolinska Institute, 141 86, Stockholm, Sweden. gabriel.sandblom@ki.se.
authors.forename: Gabriel
authors.identifier: http://orcid.org/0000-0002-7416-4951
authors.initials: G
authors.lastname: Sandblom
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D013548:Sweden
keywords: Gender; Indirect hernia; Recurrence rate; Sliding hernia