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Utilization of laparoscopic and open inguinal hernia repair at a large hernia center in China: a single-center
Qiuyue Ma1, Xiaoli Liu1, Huiqi Yang2
1Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Number 5 Jingyuan Road, Shijingshan District, Beijing, 100043, China.
Insights
Laparoscopic inguinal hernia repair was used in about half of patients, more often in men and those without other health issues. Further efforts are needed to increase laparoscopic repair rates in women.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
- Gastroenterology
Background:
- The adoption of laparoscopic versus open inguinal hernia repair in China is not well-documented.
- Understanding current trends is crucial for surgical practice optimization.
Purpose of the Study:
- To determine the utilization rates of laparoscopic and open inguinal hernia repair.
- To identify factors associated with the choice of surgical approach in a large Chinese hernia center.
Main Methods:
- Retrospective analysis of adult inguinal hernia inpatient data from 2013-2020.
- Comparison of laparoscopic repair rates across demographic and hernia characteristic groups.
- Multivariable logistic regression to identify predictors of laparoscopic repair.
Main Results:
- Out of 14,481 patients, 49.47% underwent laparoscopic repair and 50.53% underwent open repair.
- Laparoscopic repair was less common in women, older patients (>70 years), and those with comorbidities or obstructed hernias.
- Factors favoring laparoscopic repair included male sex, younger age, bilateral hernias, and direct inguinal hernias.
Conclusions:
- Laparoscopic inguinal hernia repair is utilized in approximately half of cases at this large center.
- Opportunities exist to enhance laparoscopic repair adoption, particularly among female patients and those with specific hernia types or comorbidities.
- Further research should focus on improving access and outcomes for laparoscopic inguinal hernia repair in diverse patient populations.
Background:
The utilization of laparoscopic and open inguinal hernia repair in China remains unclear. We aim to investigate the rates of laparoscopic and open inguinal hernia repairs and its associated factors at a large hernia center.
Methods:
Data were obtained from the front sheet of medical records of Beijing Chaoyang hospital. Adult inguinal hernia inpatients who underwent hernia repairs between 2013 and 2020 were included. We calculated the overall rates of laparoscopic and open inguinal hernia repairs and compared the rate of laparoscopic repairs between different sex, age groups, types, and sides of inguinal hernias. Multivariable logistic regression was used to examine factors associated with the rate of laparoscopic repairs.
Results:
14,481 inpatients with inguinal hernia were included. 91.78% were male, 75.43% were more than 50 years, 75.20% were unilateral inguinal hernia, and 64.57% were indirect inguinal hernia. Overall, 49.47% underwent laparoscopic repairs and 50.53% underwent open repairs. Women had lower rate of laparoscopic repair than men, especially in those with unilateral hernias. Bilateral and direct inguinal hernia had higher rates of laparoscopic repair than unilateral and indirect inguinal hernia. Multivariable logistic regression showed that inpatients who were women, > 70 years, pantaloon inguinal hernia, with obstruction, and more comorbidities were less likely to have laparoscopic repairs.
Conclusion:
Around 50% of inguinal hernia patients at a large hernia center underwent laparoscopic repairs, which was more commonly performed in male, young, bilateral inguinal hernia, and inpatients without comorbidities. More efforts were needed to increase the safe and effective laparoscopic utilization among female patients with inguinal hernias.
