Schjøth-Iversen L, et al. - The present study was planned to assess the independent risk factors for recurrence within 2 years after total extraperitoneal repair (TEP). Findings revealed higher recurrence rate after TEP in comparison to that reported after open hernia repair. Good surgical technique with precise dissection and correct placement of the mesh, especially in medial hernias and obese patients, seemed to be the key points to improve outcomes after TEP.

Methods

• Authors performed a single-centre prospective cohort study with consecutive inclusion of patients undergoing inguinal hernia repair from 2010 to 2014.
• 6 months and 2 years postoperatively, systematic follow-up was conducted.
• After 2 years, analysis of risk factors for recurrence was performed in univariate and multivariate analyses.

Results

• TEP was performed on 1194 patients for inguinal or femoral hernia in the study period, of which 1047 were eligible for analyses.
• After 2 years, recurrence was observed in 56 (5.3%) patients.
• As per univariate analyses, factors associated with recurrence included: body mass index (BMI) >30 (HR 3.64; p = 0.011), medial vs. lateral hernia (HR 2.37; p = 0.004), repair of recurrent hernia vs. primary repair (HR 2.12; p = 0.049), and length of stay >1 day (HR 1.77; p = 0.043).
• Multivariate analyses suggested that factors independently associated with recurrence after 2 years were BMI >30 (HR 3.74; p = 0.026) and medial vs. lateral hernia (HR 2.39; p = 0.004).