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BMC Surg. 2019 Aug 7;19(1):103. doi: 10.1186/s12893-019-0569-6.

Incisional hernia recurrence after open elective repair: expertise in abdominal wall surgery matters.

Author information

1
Servicio de Cirugía General y del Aparato Digestivo, Parc de Salut Mar. Hospital del Mar. P, Marítim 23-25, 08003, Barcelona, Spain. jose.pereira@upf.edu.
2
Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Dr. Aiguader 80, 08003, Barcelona, Spain. jose.pereira@upf.edu.
3
Servicio de Cirugía General y del Aparato Digestivo, Parc de Salut Mar. Hospital del Mar. P, Marítim 23-25, 08003, Barcelona, Spain.
4
Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Dr. Aiguader 80, 08003, Barcelona, Spain.
5
Servicio de Cirugía General y Digestiva, Hospital Vall d'Hebrón, Passeig Vall d'Hebrón 119-129, 08035, Barcelona, Spain.
6
Departament de Cirurgia. Vall d'Hebrón, Universitat Autònoma de Barcelona, Passeig Vall d'Hebrón 119-129, 08035, Barcelona, Spain.

Abstract

BACKGROUND:

Recurrence after incisional hernia repair is one of the major problems related with this operation. Our objective is to analyze the influence of abdominal wall surgery expertise in the results of the open elective repair of incisional hernia.

METHODS:

We have compiled the data of a cohort of patients who received surgery for an incisional hernia from July 2012 to December 2015 in a University Hospital. Data were collected prospectively and registered in the Spanish Register of Incisional Hernia (EVEREG). The short- and long-term complications between the groups of patients operated on by the Abdominal Wall Surgery (AWS) unit and groups operated on by surgeons outside of the specialized abdominal wall group (GS) were compared.

RESULTS:

During the study period, a total of 237 patients were operated on by the open approach (114 AWS; 123 GS). One hundred seventy-five patients completed a median follow-up of 36.6 months [standard deviation (SD) = 6]. Groups were comparable in terms of age, sex, body mass index (BMI), comorbidities, and complexity of hernia. Complications were similar in both groups. Patients in the AWS group presented fewer recurrences (12.0% vs. 28.9%; P = 0.005). The cumulative incidence of recurrence was higher in the GS group [log rank 13.370; P < 0.001; odds ratio (OR) = 37.8; 95% confidence interval (CI) = 30.3-45.4]. In the multivariate analysis, surgery performed by the AWS unit was related to fewer recurrences (OR = 0.19; 95%CI = 0.07-0.58; P < 0.001).

CONCLUSION:

Incisional hernia surgery is associated with better results in terms of recurrence when it is performed in a specialized abdominal wall unit.

KEYWORDS:

Abdominal wall unit; Expertise; Incisional hernia; Open repair; Recurrence

PMID:
31391112
PMCID:
PMC6686257
DOI:
10.1186/s12893-019-0569-6
[Indexed for MEDLINE]
Free PMC Article

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