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Arch Surg. 2009 Sep;144(9):848-52. doi: 10.1001/archsurg.2009.161.

Open incisional hernia repair at an academic tertiary care medical center.

Author information

  • 1Division of General Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA 94143-0104, USA.

Abstract

OBJECTIVE:

To describe the postoperative complication rates of a large consecutive series of patients who underwent open incisional ventral hernia repair.

DESIGN:

Retrospective medical record review of an accumulated database.

SETTING:

University tertiary care medical center.

PATIENTS:

All patients who underwent open incisional ventral hernia repair from March 1, 2003, through February 28, 2008.

INTERVENTION:

Open incisional ventral hernia repair.

MAIN OUTCOME MEASURES:

Postoperative complications, including hernia recurrences.

RESULTS:

A total of 507 cases (465 patients; female to male ratio, 1.1:1) met our criteria; median follow-up was 40 months. In 23.5% of the cases, repair had been attempted previously, and 16.4% had previously undergone organ transplant. The postoperative complication rate was 38.1%. Hernias recurred in 18.9% of cases. Perioperative mortality was 1.0%. Patients undergoing transplant were more likely than those not undergoing transplant to have a hernia recurrence (16.3% vs 32.5%; P < .001) and were equally likely to have a postoperative complication (36.9% vs 44.6%; P = .19). Patients who underwent repair of a recurrent incisional hernia were as likely to have a hernia recurrence as those who underwent initial repair (21.0% vs 18.3%; P = .52) but more likely to have an overall complication (47.9% vs 35.1%; P = .01).

CONCLUSIONS:

In this series of incisional hernia repairs at a tertiary care center, the overall recurrence rate of 18.9% is comparable to that of other published series. Ours is the largest published series of recurrent hernias that shows a recurrence rate comparable to that for initial repairs. This outcome may be the result of greater use of more complex repair techniques.

PMID:
19797110
[PubMed - indexed for MEDLINE]
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