Hernia recurrence following inguinal hernia repair in children

Kathryn Taylor, Kristin A. Sonderman*, Lindsey L. Wolf, Wei Jiang, Lindsey B. Armstrong, Tracey P. Koehlmoos, Brent R. Weil, Robert L. Ricca, Christopher B. Weldon, Adil H. Haider, Samuel E. Rice-Townsend

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Purpose: We aimed to describe the incidence, timing, and predictors of recurrence following inguinal hernia repair (IHR) in children. Methods: We used the TRICARE claims database, a national cohort of > 3 million child dependents of members of the U.S. Armed Forces. We abstracted data on children < 12y who underwent IHR (2005–2014). Our primary outcome was recurrence (ICD9-CM diagnosis codes). We calculated incidence rates for the population and stratified by age, time from repair to recurrence, and multivariable logistic regression to determine predictors. Results: Nine thousand nine hundred ninety-three children met inclusion criteria. Age at time of IHR was ≤ 1y in 37%, 2-3y in 23%, 4–5y in 16%, and 5–12y in 24%. Median follow-up time was 3.5y (IQR:1.6–6.1). 137 patients recurred (1.4%), with an incidence of 3.46 per 1000 person-years. Over half occurred in children 0-1y at repair (60%). The majority occurred within a year following repair (median 209 days [IQR:79–486]). Children 0-1y had 2.53 times greater odds of recurrence (compared to > 5y). Children with multiple comorbidities had 5.45 times greater odds compared to those with no comorbidities. Conclusions: The incidence of recurrence following IHR is 3.46 per 1000 person-years. The majority occurred within a year of repair. Children ≤ 1y and those with multiple comorbidities were at increased risk. Level of Evidence: Prognosis Study, Level II.

Original languageEnglish
Pages (from-to)2214-2218
Number of pages5
JournalJournal of Pediatric Surgery
Volume53
Issue number11
DOIs
StatePublished - Nov 2018
Externally publishedYes

Keywords

  • Hernia recurrence
  • Inguinal hernia
  • Pediatric hernia

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