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The Capital Region of Denmark - a part of Copenhagen University Hospital
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High complication rates during and after repeated Lichtenstein or laparoscopic inguinal hernia repairs in the same groin: a cohort study based on medical records

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  1. More than one-third of Cochrane reviews had gift authors, whereas ghost authorship was rare

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  2. Group authorships in Cochrane had low compliance with Cochrane recommendations

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  3. Half of Cochrane reviews were published more than 2 years after the protocol

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PURPOSE: Performing two anterior or two posterior inguinal hernia repairs in the same groin contradict guidelines. Nevertheless, there can be indications for using the same approach at reoperation, and information on complications other than the risk of a third repair and chronic pain is lacking in the literature. The aim was to assess intraoperative events and postoperative complications after two Lichtenstein repairs or laparoscopic inguinal hernia repairs in the same groin.

METHODS: This nationwide cohort study included patients that had received two Lichtenstein repairs (Lichtenstein-Lichtenstein) or two laparoscopic (Laparoscopy-Laparoscopy) inguinal hernia repairs in the same groin. Patients were identified in the Danish Hernia Database and outcomes were identified in medical records during a period of 6 years. Outcomes were intraoperative events that deviated from a standard repair and 1-year postoperative complications classified according to the Clavien-Dindo classification. Outcomes were reported separately for the two cohorts.

RESULTS: Among the included 102 Lichtenstein reoperations, 27% of the repairs had intraoperative events, with drain placement being most common (10%). Half of the reoperations resulted in complications where infection (15%) and hematoma (12%) were most frequent. Among the 58 laparoscopic reoperations, 16% had an intraoperative event where bleeding requiring clips was most common (10%). Half of the reoperations resulted in a complication with surgery in general anesthesia in the same groin area being the most frequent complication (9%).

CONCLUSIONS: Intraoperative events and 1-year postoperative complications were high for both Lichtenstein-Lichtenstein and Laparoscopy-Laparoscopy, and the results therefore support guidelines that recommend another approach at reoperation.

Original languageEnglish
JournalHernia : the journal of hernias and abdominal wall surgery
Volume24
Issue number4
Pages (from-to)801-810
Number of pages10
ISSN1265-4906
DOIs
Publication statusPublished - Aug 2020

ID: 60988283