ABSTRACT
BACKGROUND AND AIMS: A high body mass index (BMI) is considered a risk factor for ventral abdominal wall hernias but protective for the development of groin hernias. The reason for this is unclear. The surrounding abdominal fat in obesity might "protect" and limit the passage through the inguinal canal. The aim was to compare two different methods used for obesity registration in groin hernia patients and to investigate the hypothesis of high BMI/low groin hernia risk phenomenon. METHODS: This was a population-based observational study comparing BMI to waist circumference (WC) as well as their correlations to the quantity of groin hernia repair performed in either sex. Two national registers were crosslinked to a large regional register including information on WC. RESULTS: A larger WC and a higher BMI were associated with a lower risk of having groin hernia repair in both sexes. There was no difference using either WC or BMI as a risk factor for groin hernia repair in either sex. There was no advantage to using body composition based on WC rather than BMI for surgery indication. CONCLUSIONS: Overweight patients, both men and women, have a lower risk of undergoing groin hernia repair regardless of fat distribution. BMI is a well-established method for obesity registration and is recommended in the evaluation of hernia patients.
Subject(s)
Hernia, Femoral , Hernia, Inguinal , Body Mass Index , Female , Groin/surgery , Hernia, Femoral/surgery , Hernia, Inguinal/epidemiology , Hernia, Inguinal/surgery , Herniorrhaphy , Humans , Male , Risk Factors , Waist CircumferenceABSTRACT
PURPOSE: The pathogenesis of groin hernia is not fully understood and some suggested risk factors are debatable. This population-based study evaluates the association between groin hernia repair and tobacco use. METHOD: An observational study based on register linkage between the Swedish Hernia Register and the Västerbotten Intervention Program (VIP). All primary groin hernia repairs performed from 2001 to 2013 in the county of Västerbotten, Sweden, were included. RESULTS: VIP provided data on the use of tobacco in 102,857 individuals. Neither smoking nor the use of snus, increased the risk for requiring a groin hernia repair. On the contrary, heavy smoking decreased the risk for men, HR 0.75 (95% CI 0.58-0.96), as did having a BMI over 30 kg/m2 HR (men) 0.33 (95% CI 0.27-0.40). CONCLUSION: Tobacco use is not a risk factor for requiring a groin hernia repair, whereas having a low BMI significantly increases the risk.
