Recurrence and complications after sliding inguinal hernia repair

Purpose Sliding hernia is a rare finding and it remains controversial if a laparoscopic or an open (Lichenstein) technique is preferable for repair of sliding hernias. The aim of this study was to investigate the risk of post-operative complications and risk of reoperation due to recurrence in patients with sliding hernia based on surgical technique. Method The study included male patients receiving hernia repair between 1 January 2010 and 31 December 2017. The data was obtained from the National Danish Hernia Database. Results A total of 32,396 hernia repairs were included. 13.5% presented with sliding hernia. No difference was found in postoperative complications comparing sliding and non-sliding lateral hernias (5.1% vs 4.2% at 90 days of follow up). Patients treated with a Lichenstein repair had a higher risk of minor complications compared to a laparoscopic repair, however the risk was overall low (1.9% vs 0.8%). Overall 3.1% had surgical repair of recurrence, a higher risk was found among patients with sliding hernia (4.3% vs 2.9%), particularly among those having a Lichenstein repair (OR 2.07, 95% CI 1.11-3.85). Conclusion A low risk of complications and recurrence after repair of both sliding and non-sliding hernia was found. Among patients with sliding hernia the risk of recurrence was lower in patient having hernia repair using laparoscopic technique although in both groups the risk was low. Sliding hernias can be treated safely using both Lichenstein and laparoscopic techniques.