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Temporal patterns for inguinal hernia recurrence operations after Shouldice Repair.

Fernando Ac Spencer Netto¹, Christoph Paasch^1,2, Ayse Yilbas¹

¹Department of Surgery, Shouldice Hospital, 7750 Bayview Ave., Thornhill, ON, L3T 4A3, Canada.

Hernia : the Journal of Hernias and Abdominal Wall Surgery

|January 27, 2024

Summary

Recurrent inguinal hernias after Shouldice Repair show age-related temporal patterns. Older patients experience earlier recurrences, a key factor for postoperative assessment and management.

Keywords:

Recurrence Relapse Reoperation Shouldice repair Temporal pattern

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Area of Science:

General Surgery
Hernia Repair
Surgical Outcomes

Background:

The Shouldice Repair is a common surgical technique for inguinal hernias, known for its low recurrence rates.
However, specific risk factors contributing to hernia recurrence after a primary Shouldice Repair remain incompletely understood.

Purpose of the Study:

To investigate the risk factors associated with recurrence following a primary Shouldice Repair for inguinal hernias.
To analyze the temporal patterns of recurrence in relation to patient age.

Main Methods:

A retrospective review of patients undergoing reoperation for recurrent inguinal hernias between 2013 and 2017.
Selection of patients with their first recurrence after a primary Shouldice Repair at the institution.
Data collection included details from the initial surgery and reoperation, followed by statistical analysis.

Main Results:

The study included 125 patients (97% male, mean age 50.8 years).
The most frequent interval for reoperation was within the first 5 years post-surgery (37.6%), with a median of 7 years.
A temporal pattern of recurrence was observed: patients under 41 recurred after a median of 20 years, those aged 41-60 after 10 years, and those over 61 after 2 years.

Conclusions:

Reoperations for recurrent inguinal hernias after Shouldice Repair exhibit age-dependent temporal recurrence patterns.
Older patients tend to experience earlier recurrences compared to younger patients.
This age-related pattern is crucial for postoperative patient assessment and management strategies.