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Rosca R, Paduraru DN, Bolocan A, Musat F, Ion D, Andronic O. A Comprehensive Review of Inguinal Hernia Occurrence in Obese Individuals. MAEDICA 2023; 18:692-698. [PMID: 38348082 PMCID: PMC10859212 DOI: 10.26574/maedica.2023.18.4.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Inguinal hernia repair is one of the most commonly performed surgical activities worldwide. Given the circumstances, understanding and identifying the risk and the protective factors is an essential step in order to prevent, diagnose and treat such a common condition. For a long time, obesity was generally considered to be a risk factor in the occurrence of an inguinal hernia. Studies have provided some unexpected data, suggesting that it might actually be a protective factor. This review aims to provide an overview on this topic, taking into account systemic aspects such as collagen distribution and metabolism. In inguinal hernia patients, the ratio between type I collagen and type III collagen is decreased, with type III collagen being responsible for the weakness of the abdominal wall. In obese patients, the extracellular matrix becomes richer in collagen, especially type I collagen, which will generate strength and stiffness. Obesity seems to be a protective factor indeed, but in order to understand the underlying mechanism and to choose the optimal surgical approach, further research is needed.
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Affiliation(s)
- Ruxandra Rosca
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Dan Nicolae Paduraru
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- University Emergency Hospital Bucharest, Romania
| | - Alexandra Bolocan
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- University Emergency Hospital Bucharest, Romania
| | - Florentina Musat
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- University Emergency Hospital Bucharest, Romania
| | - Daniel Ion
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- University Emergency Hospital Bucharest, Romania
| | - Octavian Andronic
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- University Emergency Hospital Bucharest, Romania
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Dahlstrand U, Melkemichel M, Österberg J, Montgomery A, de la Croix H. Female Groin Hernia Repairs in the Swedish Hernia Register 1992-2022: A Review With Updates. JOURNAL OF ABDOMINAL WALL SURGERY : JAWS 2023; 2:11759. [PMID: 38312425 PMCID: PMC10831639 DOI: 10.3389/jaws.2023.11759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/07/2023] [Indexed: 02/06/2024]
Abstract
Introduction: Groin hernias in women is much less common than in men; it constitutes only 9% of all groin hernia operations. Historically, studies have been performed on men and the results applied to both genders. However, prospectively registered operations within national registers have contributed to new knowledge regarding groin hernias in women. The aim of this paper was to investigate and present a body of literature based upon the Swedish Hernia Register together with recent data from the register's annual report. Patients and Methods: PubMed and Embase were searched for studies based on the Swedish Hernia Register between 1992 and 2023. Based on the initial reading of abstracts, studies that presented results separately for women were selected and read. Recent data were acquired from the 2022 annual report of the Swedish Hernia Register. Results: A total of 73 studies of interest were identified. Of these, 52 included women, but only 19 presented separate results for women. Four themes emerged and were analysed further: emergency surgery and mortality, femoral hernias, the risk of reoperation for recurrence, and chronic pain following female groin hernia repairs. Discussion: Studies from the Swedish Hernia Register clearly describe that both the presentation of hernias and outcomes after repair differ significantly between the two genders. The differences that have been identified over the years have been incorporated into the national guidelines. Register data indicates that the guidelines have been implemented and are fairly well adhered to. As a result, significant improvements in outcomes regarding recurrences have been made for women with groin hernias in Sweden.
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Affiliation(s)
- Ursula Dahlstrand
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Enköping Hospital, Enköping, Sweden
| | - Maria Melkemichel
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Södertälje Hospital, Södertälje, Sweden
| | - Johanna Österberg
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Surgery, Mora Hospital, Mora, Sweden
| | - Agneta Montgomery
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Hanna de la Croix
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Chan KH, Wright N, Xiao D, Guo Y, Chen Y, Du H, Yang L, Millwood IY, Pei P, Wang J, Turnbull I, Gilbert S, Avery D, Kartsonaki C, Yu C, Chen J, Lv J, Clarke R, Collins R, Peto R, Li L, Wang C, Chen Z. Tobacco smoking and risks of more than 470 diseases in China: a prospective cohort study. Lancet Public Health 2022; 7:e1014-e1026. [PMID: 36462513 PMCID: PMC7613927 DOI: 10.1016/s2468-2667(22)00227-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/25/2022] [Accepted: 08/26/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Tobacco smoking is estimated to account for more than 1 million annual deaths in China, and the epidemic continues to increase in men. Large nationwide prospective studies linked to different health records can help to periodically assess disease burden attributed to smoking. We aimed to examine associations of smoking with incidence of and mortality from an extensive range of diseases in China. METHODS We analysed data from the prospective China Kadoorie Biobank, which recruited 512 726 adults aged 30-79 years, of whom 210 201 were men and 302 525 were women. Participants who had no major disabilities were identified through local residential records in 100-150 administrative units, which were randomly selected by use of multistage cluster sampling, from each of the ten diverse study areas of China. They were invited and recruited between June 25, 2004, and July 15, 2008. Upon study entry, trained health workers administered a questionnaire assessing detailed smoking behaviours and other key characteristics (eg, sociodemographics, lifestyle, and medical history). Participants were followed up via electronic record linkages to death and disease registries and health insurance databases, from baseline to Jan 1, 2018. During a median 11-year follow-up (IQR 10-12), 285 542 (55·7%) participants were ever hospitalised, 48 869 (9·5%) died, and 5252 (1·0%) were lost to follow-up during the age-at-risk of 35-84 years. Cox regression yielded hazard ratios (HRs) associating smoking with disease incidence and mortality, adjusting for multiple testing. FINDINGS At baseline, 74·3% of men and 3·2% of women (overall 32·4%) ever smoked regularly. During follow-up, 1 137 603 International Classification of Diseases, 10th revision (ICD-10)-coded incident events occurred, involving 476 distinct conditions and 85 causes of death, each with at least 100 cases. Compared with never-regular smokers, ever-regular smokers had significantly higher risks for nine of 18 ICD-10 chapters examined at age-at-risk of 35-84 years. For individual conditions, smokers had significantly higher risks of 56 diseases (50 for men and 24 for women) and 22 causes of death (17 for men and nine for women). Among men, ever-regular smokers had an HR of 1·09 (95% CI 1·08-1·11) for any disease incidence when compared with never-regular smokers, and significantly more episodes and longer duration of hospitalisation, particularly those due to cancer and respiratory diseases. For overall mortality, the HRs were greater in men from urban areas than in men from rural areas (1·50 [1·42-1·58] vs 1·25 [1·20-1·30]). Among men from urban areas who began smoking at younger than 18 years, the HRs were 2·06 (1·89-2·24) for overall mortality and 1·32 (1·27-1·37) for any disease incidence. In this population, 19·6% of male (24·3% of men residing in urban settings and 16·2% of men residing in rural settings) and 2·8% of female deaths were attributed to ever-regular smoking. INTERPRETATION Among Chinese adults, smoking was associated with higher risks of morbidity and mortality from a wide range of diseases. Among men, the future smoking-attributed disease burden will increase further, highlighting a pressing need for reducing consumption through widespread cessation and uptake prevention. FUNDING British Heart Foundation, Cancer Research UK, Chinese Ministry of Science and Technology, Kadoorie Charitable Foundation, UK Medical Research Council, National Natural Science Foundation of China, Wellcome Trust.
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Affiliation(s)
- Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, UK
| | - Neil Wright
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Dan Xiao
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Guo
- National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
| | - Junzheng Wang
- Licang Center of Disease Control and Prevention, Qingdao, China
| | - Iain Turnbull
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Simon Gilbert
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Daniel Avery
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Christiana Kartsonaki
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Richard Peto
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China.
| | - Chen Wang
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
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Ahtinen M, Vironen J, Murtola TJ. The risk of inguinal hernia repair after radical prostatectomy - a population-based cohort study. Scand J Urol 2022; 56:191-196. [PMID: 35451920 DOI: 10.1080/21681805.2022.2065357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES A nationwide population-based register study will evaluate the risk of postoperative inguinal hernia repair after primary curative-intent treatment of prostate carcinoma (PCa). BACKGROUND Several previous studies have suggested an increased risk of inguinal hernia repair after prostatectomy. Only a few studies have compared the risk by PCa treatment modalities. METHODS Data were collected between the years 1998 and 2016 from the national hospital discharge database HILMO and between the years 1998 and 2015 from the Finnish cancer registry to identify all men with prostate cancer with data on primary treatment available and information on inguinal hernia diagnoses and procedures among them. The risk of inguinal hernia repair among men managed with prostatectomy was compared to those treated with radiation therapy. Participants treated with prostatectomy were analyzed as a whole and separately stratified into subgroups managed with mini-invasive or open surgery. Multivariate Cox regression with adjustment for age and comorbidities was used for analysis. RESULTS A total of 7207 cases of PCa were included in the study. 4595 men were treated with radical prostatectomy and 2612 with radiation therapy. Overall, the risk of hernia repair was higher among men treated with prostatectomy compared to men who received radiation therapy as the primary PCa treatment (HR 1.42, 95% CI 1.14-1.77). The risk did not differ markedly by the prostatectomy method. CONCLUSION Prostate cancer treatment with prostatectomy is associated with an increased risk of inguinal hernia surgery than external beam radiation therapy treatment. This risk should be taken into account when planning PCa treatment.
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Affiliation(s)
- Mikko Ahtinen
- Department of Surgery, TAYS Cancer Center, Tampere, Finland
| | - Jaana Vironen
- Abdominal Center, Helsinki University and University Hospital, Helsinki, Finland
| | - Teemu J Murtola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Urology, TAYS Cancer Center, Tampere, Finland
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Williams ML, McCarthy ASE, Lord SJ, Aczel T, Brooke-Cowden GL. Impact of ultrasound on inguinal hernia repair rates in Australia: a population-based analysis. ANZ J Surg 2021; 91:1604-1609. [PMID: 33870618 DOI: 10.1111/ans.16845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/09/2021] [Accepted: 03/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Inguinal hernias are a common pathology that often requires surgical management. The use of groin ultrasound (GU) to investigate inguinal hernias is a growing area of concern as an inefficient use of healthcare resources. Our aim was to assess changes in the rates of GU and the impact on surgical practice. METHODS Medicare Item Reports and the Australian Institute of Health and Welfare Database were used to estimate annual GU and inguinal hernia repair (IHR) rates per 100 000 population for the period 2000/2001-2017/2018. Pearson's correlation coefficients and linear regression analyses were performed to assess associations between these variables. RESULTS Over the 18-year period, GU rates increased 13-fold from 88 to 1174 per 100 000 population. Overall, total IHR rates decreased from 217 to 192 per 100 000. Overall, unilateral IHR rates have decreased (182-146 per 100 000), bilateral IHRs have increased (35-46 per 100 000), laparoscopic IHR has increased (30-86 per 100 000) and open surgery has declined (187-106 per 100 000). The increase in GU rates were strongly associated with the decrease in unilateral (r = -0.936, P = <0.001) and increase in bilateral IHR rates (r = 0.924, P = <0.001). CONCLUSION The use of GU has increased substantially, potentially representing an unnecessary cost to the healthcare system. Rising GU rates are not associated with an increase in IHR, however, may contribute to the increasing rates of bilateral IHRs. This study supports the opinion that more extensive clinical and health policy initiatives are needed in Australia to address this health issue.
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Affiliation(s)
- Michael L Williams
- Department of Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,The School of Medicine Sydney, The University of Notre Dame, Sydney, New South Wales, Australia
| | | | - Sally J Lord
- The School of Medicine Sydney, The University of Notre Dame, Sydney, New South Wales, Australia
| | - Thomas Aczel
- The School of Medicine Sydney, The University of Notre Dame, Sydney, New South Wales, Australia.,Department of Surgery, Hawkesbury Hospital, Sydney, New South Wales, Australia
| | - Geoffrey L Brooke-Cowden
- The School of Medicine Sydney, The University of Notre Dame, Sydney, New South Wales, Australia.,Department of Surgery, Auburn Hospital, Sydney, New South Wales, Australia
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Khalaf AZ. Pattern of inguinal hernia in Al- Basra teaching hospital: a prospective clinical study. ALEXANDRIA JOURNAL OF MEDICINE 2021. [DOI: 10.1080/20905068.2021.1880042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Ahmed Ziarra Khalaf
- Specialist Surgeon, Department of Surgery, Al-Basra Teaching Hospital, Basra, Iraq
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Williams ML, Hutchinson AG, Oh DD, Young CJ. Trends in Australian inguinal hernia repair rates: a 15‐year population study. ANZ J Surg 2020; 90:2242-2247. [DOI: 10.1111/ans.16192] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/28/2020] [Accepted: 07/09/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Michael L. Williams
- Department of Colorectal Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia
| | - Adam G. Hutchinson
- Department of General Surgery Bendigo Hospital Bendigo Victoria Australia
| | - Daniel D. Oh
- Department of Colorectal Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia
| | - Christopher J. Young
- Department of Colorectal Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia
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Risk of hernia formation after radical prostatectomy: a comparison between open and robot-assisted laparoscopic radical prostatectomy within the prospectively controlled LAPPRO trial. Hernia 2020; 26:157-164. [PMID: 32279170 PMCID: PMC8881255 DOI: 10.1007/s10029-020-02178-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/20/2020] [Indexed: 12/23/2022]
Abstract
Purpose In addition to incisional hernia, inguinal hernia is a recognized complication to radical retropubic prostatectomy. To compare the risk of developing inguinal and incisional hernias after open radical prostatectomy compared to robot-assisted laparoscopic prostatectomy. Method Patients planned for prostatectomy were enrolled in the prospective, controlled LAPPRO trial between September 2008 and November 2011 at 14 hospitals in Sweden. Information regarding patient characteristics, operative techniques and occurrence of postoperative inguinal and incisional hernia were retrieved using six clinical record forms and four validated questionnaires. Results 3447 patients operated with radical prostatectomy were analyzed. Within 24 months, 262 patients developed an inguinal hernia, 189 (7.3%) after robot-assisted laparoscopic prostatectomy and 73 (8.4%) after open radical prostatectomy. The relative risk of having an inguinal hernia after robot-assisted laparoscopic prostatectomy was 18% lower compared to open radical retropubic prostatectomy, a non-significant difference. Risk factors for developing an inguinal hernia after prostatectomy were increased age, low BMI and previous hernia repair. The incidence of incisional hernia was low regardless of surgical technique. Limitations are the non-randomised setting. Conclusions We found no difference in incidence of inguinal hernia after open retropubic and robot-assisted laparoscopic radical prostatectomy. The low incidence of incisional hernia after both procedures did not allow for statistical analysis. Risk factors for developing an inguinal hernia after prostatectomy were increased age and BMI. Electronic supplementary material The online version of this article (10.1007/s10029-020-02178-7) contains supplementary material, which is available to authorized users.
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Besch BM, Curtin K, Ritch R, Allingham RR, Wirostko BM. Association of Exfoliation Syndrome With Risk of Indirect Inguinal Hernia: The Utah Project on Exfoliation Syndrome. JAMA Ophthalmol 2019; 136:1368-1374. [PMID: 30242396 DOI: 10.1001/jamaophthalmol.2018.4157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Importance Exfoliation syndrome (XFS) is a systemic connective tissue disease, and abnormal connective tissue metabolism is implicated in inguinal hernias (IH). Associating XFS with comorbid conditions may illuminate their underlying pathophysiology and affect clinical screening and treatment. Exfoliation syndrome involves altered systemic extracellular matrix (ECM) homeostasis involving elastin metabolism. Hernias occur owing to abnormal ECM synthesis, metabolism, or repair. Inguinal hernias involve weakening or rupture of the abdominal/groin wall. Objective To determine an association between patients with XFS and patients with IH in Utah, possibly differing between direct or indirect hernia. Design, Setting, and Participants Cross-sectional study in a large health care system of Utah hospitals and clinics. Conditional logistic regression odds ratios were used to estimate risk of XFS in patients with IH overall and by subtype (direct or indirect) compared with control individuals. Codes specific to direct and indirect IH with additional medical records review of 186 procedures were used to classify IH subtypes that were not prespecified. Bootstrap resampling with jackknife estimation used to calculate 95% confidence intervals. The model accounted for matching on sex and age and adjusted for body mass index and tobacco use. Population-based sample using medical records from 1996 to 2015 that identified 2594 patients 40 years or older on January 1, 1996, with surgical IH repair and 12 966 random control patients with no IH history matched 5:1 on sex and birth year. Data were analyzed between September 10, 2017, and October 23, 2017. Main Outcomes and Measures Exfoliation syndrome outcome defined by diagnosis codes for XFS or exfoliation glaucoma from 1996 to 2015. Results Participants were primarily white (2532 of 2594 patients, [96.1%]; 12 454 of 12 966 control individuals [97.6%]) and non-Hispanic (2396 of 2594 patients [92.4%]); 250 participants were women (9.6%). Of study participants, 22 patients with IH and 43 control individuals were diagnosed as having XFS, respectively. Patients with IH had a 2.3-fold risk for an XFS diagnosis compared with control individuals (95% CI, 1.4-3.5; P = .03), and XFS risk with indirect IH appeared especially pronounced. Conclusions and Relevance Inguinal hernia was associated with an increased risk of XFS in this Utah population. Further work is needed to understand the pathophysiology, genetics, and environmental factors contributing to both diseases.
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Affiliation(s)
- Brian M Besch
- John Moran Eye Center, Department of Ophthalmology and Visual Science, University of Utah School of Medicine, Salt Lake City
| | - Karen Curtin
- John Moran Eye Center, Department of Ophthalmology and Visual Science, University of Utah School of Medicine, Salt Lake City.,Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York
| | - R Rand Allingham
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Barbara M Wirostko
- John Moran Eye Center, Department of Ophthalmology and Visual Science, University of Utah School of Medicine, Salt Lake City
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Kulacoglu H, Köckerling F. Hernia and Cancer: The Points Where the Roads Intersect. Front Surg 2019; 6:19. [PMID: 31024927 PMCID: PMC6460227 DOI: 10.3389/fsurg.2019.00019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 03/18/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction: This review aimed to present common points, intersections, and potential interactions or mutual effects for hernia and cancer. Besides direct relationships, indirect connections, and possible involvements were searched. Materials and Methods: A literature search of PubMed database was performed in July 2018 as well as a search of relevant journals and reference lists. The total number of screened articles was 1,422. Some articles were found in multiple different searches. A last PubMed search was performed during manuscript writing in December 2018 to update the knowledge. Eventually 427 articles with full text were evaluated, and 264 included, in this review. Results: There is no real evidence for a possible common etiology for abdominal wall hernias and any cancer type. The two different diseases had been found to have some common points in the studies on genes, integrins, and biomarkers, however, to date no meaningful relationship has been identified between these points. There is also some, albeit rather conflicting, evidence for inguinal hernia being a possible risk factor for testicular cancer. Neoadjuvant or adjuvant therapeutic modalities like chemotherapy and radiotherapy may cause postoperative herniation with their adverse effects on tissue repair. Certain specific substances like bevacizumab may cause more serious complications and interfere with hernia repair. There are only two articles in PubMed directly related to the topic of "hernia and cancer." In one of these the authors claimed that there was no association between cancer development and hernia repair with mesh. The other article reported two cases of squamous-cell carcinoma developed secondary to longstanding mesh infections. Conclusion: As expected, the relationship between abdominal wall hernias and cancer is weak. Hernia repair with mesh does not cause cancer, there is only one case report on cancer development following a longstanding prosthetic material infections. However, there are some intersection points between these two disease groups which are worthy of research in the future.
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Affiliation(s)
| | - Ferdinand Köckerling
- Department of Surgery, Centre for Minimally Invasive Surgery, Vivantes Klinikum, Berlin, Germany
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