Evolving Inguinal Hernia Repair Practice at the Veterans Health Administration

作者：Emma Bradley, Kathryn A. Schlosser, Michael E. Matheny, Richard A. Pierce · 发表于：JAMA Surgery · 年份：2026 · DOI：10.1001/jamasurg.2026.0307 · 被引用次数：3 · 研究领域：Hernia repair and management、Aortic aneurysm repair treatments、Hip and Femur Fractures

Importance: Inguinal hernia repair (IHR) is one of the most commonly performed operations in the United States, with approximately 800 000 performed each year. US veterans are a unique group that is predominantly male and tends to have higher rates of medical comorbidities and tobacco use, common risk factors for hernia development. With significant advancements in IHR technique in recent years, the majority of national database studies have focused on civilian populations. Objective: To examine trends and the evolution of IHR within the Veterans Health Administration (VHA) over the past 20 years. Design, Setting, and Participants: This cohort study examined national data retrospectively from all VHA institutions in the period 2002 to 2022. Participants were veterans who received IHR within the VHA were identified through the Corporate Data Warehouse using procedure and diagnosis codes. Data were analyzed from January to April 2025. Exposure: Inguinal hernia repair. Main Outcomes and Measures: Surgical volumes and trends in IHR surgical approach across the VHA were examined over time. Additional measures included procedural urgency and surgical setting. Results: A total of 308 876 veterans underwent IHR from 2002 to 2022. Patients were predominantly male (306 905 [99.4%]; 1971 female patients [0.6%]), with a median (IQR) age of 65 (57-73) years. They had high rates of hypertension (198 792 [64.4%]), depression (102 880 [33.3%]), chronic obstructive pulmonary disease (82 608 [...