Erik Axman: Evaluating the outcomes after inguinal hernia surgery
Surgery for inguinal hernias is among the most common procedures in Sweden. Erik Axman’s doctoral thesis evaluates the outcomes of different surgical techniques. Furthermore, he emphasizes the necessity for a dedicated inguinal hernia registry for children to enhance pediatric hernia surgery.
ERIK AXMAN
Dissertation defense: 17 May 2024 (click for details)
Doctoral thesis: Outcomes of inguinal hernia surgery. Combining and exploring data from national registers in Sweden
Research area: Surgery
Sahlgrenska Academy, The Institute of Clinical Sciences
Approximately one-third of men and one-twentieth of women experience inguinal hernias during their lifetime. It’s caused by a weakening in the abdominal wall where both peritoneum and abdominal contents can be pressed out at the groin. It appears as a bulge on the skin and can cause discomfort and pain.
What is the focus of your thesis?
“My research revolves around utilizing data from the Swedish Hernia Registry to examine the outcomes of inguinal hernia surgeries, combining information from other registries and patient-related outcome measures. The evaluation in this thesis primarily focuses on the risks of hernia recurrence and prolonged post-operative pain,” says Erik Axman, who conducts research at the Institute of Clinical Sciences and works as a general surgery specialist and resident physician at the Pediatric Surgery Unit, Queen Silvia Children’s Hospital.
”Better outcomes in women”
What are the key findings of your research?
“The Swedish Hernia Registry includes over 90% of surgeries in Sweden, and the registry’s data aligns with patient records. Employing self-adhesive mesh in surgery doesn’t reduce pain risk but doesn’t increase the likelihood of hernia recurrence either, accompanied by shorter operation durations. Inguinal hernias don’t correlate with heightened risk of anastomotic leak in colorectal cancer surgery.”
Erik Axman’s registry studies demonstrate that the outcomes of surgeries have improved over time.
“Over the past 30 years, the risk of needing surgery for a recurrence of inguinal hernia has significantly decreased. Women have transitioned from having poorer outcomes to having better results than men regarding the risk of needing a new operation. Laparoscopic surgeries for women are associated with the best results.”
Lack of registries for children
What challenges have you encountered in your doctoral project?
“I’ve worked in a small research group with colleagues spread across Sweden, which has been enjoyable but also comes with its challenges. Combining research with clinical work can be intense at times but also rewarding,” says Erik Axman, and continues:
“As a surgeon, I’ve transitioned from treating adult patients to now treating children. One realization is that there’s a lack of inguinal hernia registry for children worldwide and in Sweden. Such a registry has the potential to enhance the quality of inguinal hernia surgery for children in Sweden.”
Text: Jakob Lundberg