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Changing the path of inguinal hernia surgery decreased the recurrence rate ten-fold. Report from a county hospital

Berndsen, F and Sevonius, Dan LU (2002) In European Journal of Surgery 168(11). p.592-596
Abstract
Objective: To audit the effect of changes in treatment of inguinal hernias on recurrence rate. Design: Retrospective analysis of consecutive patients operated on in 1990 and prospective analysis of consecutive patients operated on in 1996. Follow up with questionnaire followed by selective clinical examination. Setting: County hospital, Sweden. Subjects: 144 patients with 147 inguinal hernias operated on in 1990 and 154 patients with 165 inguinal hernias operated on in 1996. Interventions: In 1993, we changed many aspects of the treatment of inguinal hernia. We introduced new techniques such as Shouldice, Lichtenstein, and laparoscopic hernia repair. Non-absorbable polypropylene sutures replaced the braided absorbable sutures previously... (More)
Objective: To audit the effect of changes in treatment of inguinal hernias on recurrence rate. Design: Retrospective analysis of consecutive patients operated on in 1990 and prospective analysis of consecutive patients operated on in 1996. Follow up with questionnaire followed by selective clinical examination. Setting: County hospital, Sweden. Subjects: 144 patients with 147 inguinal hernias operated on in 1990 and 154 patients with 165 inguinal hernias operated on in 1996. Interventions: In 1993, we changed many aspects of the treatment of inguinal hernia. We introduced new techniques such as Shouldice, Lichtenstein, and laparoscopic hernia repair. Non-absorbable polypropylene sutures replaced the braided absorbable sutures previously used. Inguinal herniorrhaphy went from a "low status" operation to a high status operation and became a primary teaching operation for surgical residents. Main outcome measures: Recurrence rate at 5 year follow up. Results: The 5 year recurrence rate decreased from 28% in 1990 to 3% in 1996 (p < 0.001). The median operating time increased from 35 minutes in 1990 to 78 minutes in 1996 (p < 0.001). Conclusion: Changing the strategy of inguinal hernia surgery by introducing uniform operating techniques and new materials dramatically improved the results and allowed us to achieve recurrence rates comparable to those seen in specialised hernia centres. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
quality control, inguinal hernia, recurrence rate
in
European Journal of Surgery
volume
168
issue
11
pages
592 - 596
publisher
Taylor & Francis
external identifiers
  • wos:000181861100004
  • pmid:12699094
  • scopus:0036947454
ISSN
1102-4151
DOI
10.1080/11024150201680004
language
English
LU publication?
yes
id
ea35e03f-ba70-4305-8214-45d312ab310e (old id 315207)
date added to LUP
2007-08-10 08:38:22
date last changed
2017-01-01 06:41:30
@article{ea35e03f-ba70-4305-8214-45d312ab310e,
  abstract     = {Objective: To audit the effect of changes in treatment of inguinal hernias on recurrence rate. Design: Retrospective analysis of consecutive patients operated on in 1990 and prospective analysis of consecutive patients operated on in 1996. Follow up with questionnaire followed by selective clinical examination. Setting: County hospital, Sweden. Subjects: 144 patients with 147 inguinal hernias operated on in 1990 and 154 patients with 165 inguinal hernias operated on in 1996. Interventions: In 1993, we changed many aspects of the treatment of inguinal hernia. We introduced new techniques such as Shouldice, Lichtenstein, and laparoscopic hernia repair. Non-absorbable polypropylene sutures replaced the braided absorbable sutures previously used. Inguinal herniorrhaphy went from a "low status" operation to a high status operation and became a primary teaching operation for surgical residents. Main outcome measures: Recurrence rate at 5 year follow up. Results: The 5 year recurrence rate decreased from 28% in 1990 to 3% in 1996 (p &lt; 0.001). The median operating time increased from 35 minutes in 1990 to 78 minutes in 1996 (p &lt; 0.001). Conclusion: Changing the strategy of inguinal hernia surgery by introducing uniform operating techniques and new materials dramatically improved the results and allowed us to achieve recurrence rates comparable to those seen in specialised hernia centres.},
  author       = {Berndsen, F and Sevonius, Dan},
  issn         = {1102-4151},
  keyword      = {quality control,inguinal hernia,recurrence rate},
  language     = {eng},
  number       = {11},
  pages        = {592--596},
  publisher    = {Taylor & Francis},
  series       = {European Journal of Surgery},
  title        = {Changing the path of inguinal hernia surgery decreased the recurrence rate ten-fold. Report from a county hospital},
  url          = {http://dx.doi.org/10.1080/11024150201680004},
  volume       = {168},
  year         = {2002},
}