Impact of posterior wall repair and mesh use on recurrence in inguinal hernia repair for adolescents and young adults

Abstract

Objective: The study aimed to evaluate the efficacy of mesh use and posterior wall repair (PWR) during inguinal hernia repair in adolescents and young adults. Methods: A total of 29,149 patients aged 12 to 30 who underwent inguinal hernia repair were selected from the Korean National Health Insurance claims data. Patients were divided into two groups: 12–18 years old and 19–30 years old. The recurrence rate and prevalence of chronic pain were compared depending on whether PWR was performed or mesh was used. Results: The recurrence rates between high ligation and high ligation with PWR were not significantly different in both groups (2.3 % vs. 2.6 %; 2.6 % vs. 3.0 %; p = 0.285 and 0.168 for patients aged 12–18 and 19–30, respectively). The use of mesh was associated with a reduced recurrence rate in patients aged 19–30 (3.1 % vs. 1.9 % in no mesh vs. mesh use; p = 0.005); however, it was not significant in patients aged 12–18 (2.7 % vs. 2.1 % in no mesh vs. mesh use; p = 0.541). In multivariate analysis, nonuse of mesh was an independently significant factor associated with recurrence in patients aged 19–30, with an odds ratio of 0.62 (95 % confidence interval = 0.44–0.90; p = 0.01). Mesh use and PWR were not significant factor associated with chronic pain in all age groups. Conclusion: The results of our study indicate that the use of mesh is associated with a lower recurrence rate in young adults (aged 19–30) undergoing inguinal hernia surgery. However, no such association was observed in adolescents (aged 12–18).