RT Journal
A1 van der Linden W, Warg A, Nordin P
T1 NAtional register study of operating time and outcome in hernia repair
JF Archives of Surgery
JO Archives of Surgery
YR 2011
FD October 1
VO 146
IS 10
SP 1198
OP 1203
DO 10.1001/archsurg.2011.268
UL http://dx.doi.org/10.1001/archsurg.2011.268
AB Objectives 
                  To examine the relationship between operating time and reoperation for recurrence and other complications in groin hernia repairs.Design 
                  Observational population-based register study.Setting 
                  Data from the nationwide Swedish Hernia Register, which prospectively collects data from almost all groin hernia repairs performed in Sweden.Patients 
                  There were 123 917 primary groin hernia repairs recorded in the Swedish Hernia Register from January 1, 1998, through December 31, 2007.Main Outcome Measures 
                  Relative risk of reoperation for recurrence and odds ratios for postoperative complications in 4 operating time groups.Results 
                  The relative risk of reoperation for recurrence of all patients operated on in less than 36 minutes was 26% higher than that of all patients with an operating time of more than 66 minutes (1.26; 95% CI, 1.11-1.43). Because the Lichtenstein procedure is the standard procedure in Sweden today, its results were also analyzed separately. In this homogeneous group, the difference was even more striking with an increased relative risk of 45% (1.45; 95% CI, 1.21-1.75). The odds ratio for infection and other postoperative complications increased with increasing operating time.Conclusion 
                  A significant decrease in reoperation for recurrence with increasing operating time exhorts the hernia surgeon to avoid speed and to maintain thoroughness throughout the procedure.