Is the Recurrence Rate Higher in Obese Patients Undergoing Inguinal Hernia Surgery?

Overview

Journal Hernia

Publisher Springer

Date 2025 Feb 25

PMID 40000506

Authors

Zi-Wei Li

Ming Song

Jun Liu

Bin Jiang

Wei Hu

Xin Zheng

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aimed to evaluate whether obese patients undergoing inguinal hernia repair surgery have a higher recurrence rate and compare the clinical outcomes of obese and non-obese patients.

Materials And Methods: The databases of PubMed, EMBASE, and Cochrane Library were used to search for eligible studies from inception to November 1, 2024. Mean difference (MD), Odds ratios (OR) and 95% confidence intervals (Cl) were pooled up to analyze. The Newcastle-Ottawa Scale (NOS) scores were used to evaluate the quality of the included studies. This study was performed with Stata (V.16.0) software.

Results: A total of nine studies involving 56,833 patients were included in this study. By comparing the baseline information, we found that the obese group had Fewer older (MD=-0.08, I²=62.41%, 95%CI=-0.16 to -0.00, P = 0.04), higher BMI (MD = 2.45, I²=93.67%, 95%CI = 2.08 to 2.81, P < 0.01), more hypertension patients (OR = 1.32, I²=32.96%, 95%CI = 1.02 to 1.67, P = 0.04), more BPH (OR = 0.68, I²=0.00%, 95%CI = 0.49 to 0.94, P = 0.02) and more local anesthesia (OR = 0.82, I²=14.73%, 95%CI = 0.79 to 0.86, P < 0.01) than the none-obese group. In terms of postoperative outcomes, We found that the obese group had higher recurrence rate (OR = 1.27, I²=21.89%, 95%CI = 1.10 to 1.47, P < 0.01), more wound infection (OR = 1.43, I²=0.00%, 95%CI = 1.20 to 1.69, P < 0.01), and more overall complications (OR = 1.12, I²=28.20%, 95%CI = 1.05 to 1.20, P < 0.01).

Conclusion: Compared with the non-obese group, the obese group has a higher recurrence rate, more wound infections, and overall more complications.

References

Kingsnorth A, LeBlanc K . Hernias: inguinal and incisional. Lancet. 2003; 362(9395):1561-71. DOI: 10.1016/S0140-6736(03)14746-0. View

Primatesta P, Goldacre M . Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol. 1996; 25(4):835-9. DOI: 10.1093/ije/25.4.835. View

Li Y, Li B, Meng F . Evaluating the relationship between standing height, body mass index, body fat percentage with risk of inguinal hernia: a Mendelian randomization study. Sci Rep. 2024; 14(1):26402. PMC: 11531599. DOI: 10.1038/s41598-024-78122-x. View

Attaar M, Forester B, Kuchta K, Ujiki M, Linn J, Denham W . Higher rates of recurrence and worse quality of life in obese patients undergoing inguinal hernia repair. Hernia. 2024; 28(6):2255-2264. DOI: 10.1007/s10029-024-03154-1. View

Garvey W, Mechanick J, Brett E, Garber A, Hurley D, Jastreboff A . AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY COMPREHENSIVE CLINICAL PRACTICE GUIDELINES FOR MEDICAL CARE OF PATIENTS WITH OBESITY. Endocr Pract. 2016; 22 Suppl 3:1-203. DOI: 10.4158/EP161365.GL. View

Bray G, Look M, Ryan D . Treatment of the obese patient in primary care: targeting and meeting goals and expectations. Postgrad Med. 2013; 125(5):67-77. DOI: 10.3810/pgm.2013.09.2692. View

Powell-Wiley T, Poirier P, Burke L, Despres J, Gordon-Larsen P, Lavie C . Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation. 2021; 143(21):e984-e1010. PMC: 8493650. DOI: 10.1161/CIR.0000000000000973. View

Purnell J . What is Obesity?: Definition as a Disease, with Implications for Care. Gastroenterol Clin North Am. 2023; 52(2):261-275. DOI: 10.1016/j.gtc.2023.03.001. View

Gilden A, Catenacci V, Taormina J . Obesity. Ann Intern Med. 2024; 177(5):ITC65-ITC80. DOI: 10.7326/AITC202405210. View

10.

DeMaria E, Carmody B . Perioperative management of special populations: obesity. Surg Clin North Am. 2005; 85(6):1283-9, xii. DOI: 10.1016/j.suc.2005.09.002. View

11.

Donohoe C, Feeney C, Carey M, Reynolds J . Perioperative evaluation of the obese patient. J Clin Anesth. 2011; 23(7):575-86. DOI: 10.1016/j.jclinane.2011.06.005. View

12.

Doyle S, Lysaght J, Reynolds J . Obesity and post-operative complications in patients undergoing non-bariatric surgery. Obes Rev. 2009; 11(12):875-86. DOI: 10.1111/j.1467-789X.2009.00700.x. View

13.

Rosemar A, Angeras U, Rosengren A . Body mass index and groin hernia: a 34-year follow-up study in Swedish men. Ann Surg. 2008; 247(6):1064-8. DOI: 10.1097/SLA.0b013e31816b4399. View

14.

Zendejas B, Hernandez-Irizarry R, Ramirez T, Lohse C, Grossardt B, Farley D . Relationship between body mass index and the incidence of inguinal hernia repairs: a population-based study in Olmsted County, MN. Hernia. 2013; 18(2):283-8. PMC: 4327820. DOI: 10.1007/s10029-013-1185-5. View

15.

Ruhl C, Everhart J . Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol. 2007; 165(10):1154-61. DOI: 10.1093/aje/kwm011. View

16.

Rosemar A, Angeras U, Rosengren A, Nordin P . Effect of body mass index on groin hernia surgery. Ann Surg. 2010; 252(2):397-401. DOI: 10.1097/SLA.0b013e3181e985a1. View

17.

Huerta S, Tran N, Yi B, Pham T . Outcomes of obese compared to non-obese veterans undergoing open inguinal hernia repair: a case-control study. Hernia. 2021; 25(5):1289-1294. DOI: 10.1007/s10029-021-02382-z. View

18.

Kudsi O, Bou-Ayash N, Gokcal F . Comparison of perioperative outcomes between non-obese and obese patients undergoing robotic inguinal hernia repair: a propensity score matching analysis. Hernia. 2021; 26(4):1033-1039. DOI: 10.1007/s10029-021-02433-5. View

19.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

20.

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View