Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Vanke School of Public Health, Tsinghua University, Beijing, China.
Int J Surg. 2023 Mar 1;109(3):333-342. doi: 10.1097/JS9.0000000000000217.
Inguinal, femoral, and abdominal hernia repairs are the most common surgical procedure worldwide. However, studies on hernia disease burden are notably limited, in both developed and low-income and middle-income countries (LMICs). We investigated temporal trends in the incidence and prevalence of inguinal, femoral, and abdominal hernias at global, regional, and national levels in 204 countries and territories from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019).
Annual incident cases, prevalent cases, age-standardized incidence rates (ASIRs), and age-standardized prevalence rates (ASPRs) of inguinal, femoral, and abdominal hernias between 1990 and 2019 were extracted from the GBD 2019 study and stratified by sex, age, and location. Percentage changes in incident cases and prevalent cases, and the estimated annual percentage changes of ASIRs and ASPRs were calculated to quantify the trends in the incidence and prevalence of inguinal, femoral, and abdominal hernias. Data analysis for the present study was conducted from 15 June 2022 to 15 July 2022.
Globally, there were 32.53 million [95% uncertainty interval (UI): 27.71-37.79] prevalent cases and 13.02 million (10.68-15.49) incident cases of inguinal, femoral, and abdominal hernias in 2019, which increased by 36.00% and 63.67%, respectively, compared with 1990. Eighty-six percent of the incident cases were males, the male-to-female ratio was 6 : 1, and most patients were aged 50-69 years. India (2.45 million), China (1.95 million), and Brazil (0.71 million) accounted for more than one-third (39%) of the incident cases worldwide. From 1990 to 2019, the ASIR and ASPR showed a decreasing trend worldwide, except in Central Sub-Saharan Africa, which had an increasing trend in ASIR and ASPR.
The global incident cases and prevalent cases of inguinal, femoral, and abdominal hernias increased substantially from 1990 to 2019, with a heavier burden observed in males, older adults, and in LMICs such as India and China. In addition, the ASIR and ASPR increased substantially in Central Sub-Saharan Africa. More efforts are warranted for hernia management to reduce the burden of inguinal, femoral, and abdominal hernias, such as by providing safe hernia surgical treatment for males, older adults, and LMICs.
腹股沟疝、股疝和腹疝修补术是全球最常见的手术。然而，在发达国家和低收入及中等收入国家（LMICs），疝病负担的研究明显有限。我们使用来自 2019 年全球疾病、伤害和危险因素研究（GBD 2019）的数据，在全球、区域和国家层面调查了 204 个国家和地区 1990 年至 2019 年腹股沟、股和腹疝的发病率和患病率的时间趋势。
从 GBD 2019 研究中提取了 1990 年至 2019 年期间腹股沟、股和腹疝的年度新发病例、现患病例、年龄标准化发病率（ASIRs）和年龄标准化患病率（ASPRs），并按性别、年龄和地点进行分层。计算新发病例和现患病例的百分比变化以及 ASIRs 和 ASPRs 的估计年百分比变化，以量化腹股沟、股和腹疝发病率和患病率的趋势。本研究的数据分析于 2022 年 6 月 15 日至 7 月 15 日进行。
全球 2019 年腹股沟、股和腹疝的现患病例为 3253 万例（95%不确定区间（UI）：2771-3779），新发病例为 1302 万例（1068-1549），分别比 1990 年增加了 36.00%和 63.67%。86%的新发病例为男性，男女比例为 6:1，大多数患者年龄在 50-69 岁之间。印度（245 万）、中国（195 万）和巴西（71 万）占全球新发病例的三分之一以上（39%）。1990 年至 2019 年期间，全球 ASIR 和 ASPR 呈下降趋势，但撒哈拉以南非洲中部呈上升趋势。
1990 年至 2019 年期间，全球腹股沟、股和腹疝的新发病例和现患病例显著增加，男性、老年人和印度、中国等 LMICs 的负担更重。此外，撒哈拉以南非洲中部的 ASIR 和 ASPR 大幅增加。需要加强疝管理以减轻腹股沟、股和腹疝的负担，例如为男性、老年人和 LMICs 提供安全的疝手术治疗。
