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- Title
Linked hospital and primary care database analysis of the impact of short-term complications on recurrence in laparoscopic inguinal hernia repair.
- Authors
Bouras, G.; Burns, E.; Howell, A.; Bottle, A.; Athanasiou, T.; Darzi, A.; Burns, E M; Howell, A M
- Abstract
<bold>Objective: </bold>To study the effects of short-term complications on recurrence following laparoscopic inguinal hernia repair using routine data.<bold>Background: </bold>Linked primary and secondary care databases can evaluate the quality of inguinal hernia surgery by quantifying short- and long-term outcome together.<bold>Methods: </bold>Longitudinal analysis of linked primary care (Clinical Practice Research Datalink) and hospital administrative (Hospital Episodes Statistics) databases quantified 30-day complications (wound infection and bleeding) and surgery for recurrence after primary repair performed between 1st April 1997 and 31st March 2012.<bold>Results: </bold>Out of 41,545 primary inguinal hernia repairs, 10.3% (4296/41,545) were laparoscopic. Complications were less frequent following laparoscopic (1.8%, 78/4296) compared with open (3.5%, 1288/37,249) inguinal hernia repair (p < 0.05). Recurrence was more frequent following laparoscopic (3.5%, 84/2541) compared with open (1.2%, 366/31,859) repair (p < 0.05). Time to recurrence was shorter for laparoscopic (26.4 months SD 28.5) compared with open (46.7 months SD 37.6) repair (p < 0.05). Overall, complications were associated with recurrence (3.2%, 44/1366 with complications; 1.7%, 700/40,179 without complications; p < 0.05). Complications did not significantly increase the risk of recurrence in open hernia repair (OR = 1.49; 95% CI 0.97-2.30, p = 0.069). Complications following laparoscopic repair was significantly associated with increased risk of recurrence (OR = 7.86; 95% CI 3.46-17.85, p < 0.05).<bold>Conclusions: </bold>Complications recorded in linked routine data predicted recurrence following laparoscopic inguinal hernia repair. Focus must, therefore, be placed on achieving good short-term outcome, which is likely to translate to better longer term results using the laparoscopic approach.
- Subjects
INGUINAL hernia; PRIMARY care; LAPAROSCOPY; DATABASES; SURGERY; RISK; HOSPITAL statistics; HERNIA surgery; MEDICAL record linkage; PRIMARY health care; SURGICAL complications; DISEASE relapse; TREATMENT effectiveness
- Publication
Hernia, 2017, Vol 21, Issue 2, p191
- ISSN
1265-4906
- Publication type
journal article
- DOI
10.1007/s10029-017-1575-1