Ann Surg Treat Res.  2024 Apr;106(4):231-236. 10.4174/astr.2024.106.4.231.

High ligation with posterior wall repair for inguinal hernia repair in young adults: a nationwide cohort study

• Lee Ky
• Lee J
• Kim D
• Oh ST

• KMID: 2554483
• DOI: http://doi.org/10.4174/astr.2024.106.4.231

Abstract

Purpose
This study evaluated the difference in the recurrence of inguinal hernia in young adult patients who underwent either high ligation alone or high ligation with posterior wall repair using nationwide data.
Methods
This retrospective study included young adult patients (aged 16–30 years) who underwent surgery for inguinal hernia between June 1, 2013 and December 31, 2020. Data from the National Health Information Database from the Korea Health Insurance Service were used for this study. Patients were divided into 2 groups (high ligation alone and posterior wall repair). The primary outcome was the difference in recurrent inguinal hernia surgeries between the 2 groups.
Results
Among the 10,803 patients included in the study, 947 underwent high ligation alone, and 9,856 underwent high ligation with posterior wall repair. Recurrence was observed in 18 patients (1.9%) in the high ligation only group and 84 (0.85%) in the high ligation with posterior wall repair group. Log-rank test findings revealed that recurrence was less frequent in the high ligation with posterior wall repair group than in the high ligation only group (P = 0.003). In the multivariate analysis of factors influencing recurrence, posterior wall repair (hazard ratio, 0.241; P = 0.001) was shown to significantly lower the recurrence.
Conclusion
Posterior wall repair might be necessary for inguinal hernia repair in young adults.

Keyword

Hernia; Herniorrhaphy; Inguinal hernia; Young adult

Figure

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  Fig. 1 Flow chart of patient selection.

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  Fig. 2 Kaplan-Meier curves for recurrence in high ligation alone only (black line) and posterior wall repair (gray line).

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