J Dalenbäck1, C Andersson, D Ribokas, G Rimbäck. 1. Department of Surgery, Frölunda Specialist Hospital, Box 138, 421 22 Västra Frölunda, Gothenburg, Sweden. jan.dalenback@vgregion.se
Abstract
PURPOSE: The purpose of this study was to establish long-term outcome after elective adult umbilical hernia (AUH) repair. METHODS: Peri- and postoperative data considering all consecutive procedures at our institution during the time span from 1999 to 2009 were retrospectively gathered and followed by a questionnaire and, if needed, a clinical investigation in early 2011. RESULTS: A total of 162 patients (female/male 35 %/65 %) were operated, and 144/162 (89 %) answers were gathered, mean follow-up time 70 months; 77 % were sutured, non-mesh repairs; 94 % of all AUHs were smaller than 3 cm; and 49 % of the operations were performed under local anaesthesia. No perioperative complications were encountered. Five postoperative complications were encountered, two serious, both after mesh-based repairs. Wound infection rate (SSI) was low, 2/144 (1.4 %). 7/144 (4.9 %) recurrences were registered, none if mesh-based techniques were used, giving a recurrence rate of 6.3 % in suture-based repairs, the difference, however, not statistically significant (p = 0.141); 2 % reported persistent pain at follow-up, 89 % were overall satisfied with the outcome. CONCLUSIONS: AUH repair could be performed with low early and long-term complication rates, with low recurrence rates also after non-mesh repairs. A substantial cohort of patients will unnecessary be implanted with meshes if mesh-reinforced repairs should be used on a routine basis, that is, 16 surplus meshes to prevent one recurrence in the present study. We recommend a tailored approach to AUH repair: suture-based methods with defects smaller than 2 cm and mesh-based repairs considered if larger than that.
PURPOSE: The purpose of this study was to establish long-term outcome after elective adult umbilical hernia (AUH) repair. METHODS: Peri- and postoperative data considering all consecutive procedures at our institution during the time span from 1999 to 2009 were retrospectively gathered and followed by a questionnaire and, if needed, a clinical investigation in early 2011. RESULTS: A total of 162 patients (female/male 35 %/65 %) were operated, and 144/162 (89 %) answers were gathered, mean follow-up time 70 months; 77 % were sutured, non-mesh repairs; 94 % of all AUHs were smaller than 3 cm; and 49 % of the operations were performed under local anaesthesia. No perioperative complications were encountered. Five postoperative complications were encountered, two serious, both after mesh-based repairs. Wound infection rate (SSI) was low, 2/144 (1.4 %). 7/144 (4.9 %) recurrences were registered, none if mesh-based techniques were used, giving a recurrence rate of 6.3 % in suture-based repairs, the difference, however, not statistically significant (p = 0.141); 2 % reported persistent pain at follow-up, 89 % were overall satisfied with the outcome. CONCLUSIONS: AUH repair could be performed with low early and long-term complication rates, with low recurrence rates also after non-mesh repairs. A substantial cohort of patients will unnecessary be implanted with meshes if mesh-reinforced repairs should be used on a routine basis, that is, 16 surplus meshes to prevent one recurrence in the present study. We recommend a tailored approach to AUH repair: suture-based methods with defects smaller than 2 cm and mesh-based repairs considered if larger than that.
Authors: Buckminster Farrow; Samir Awad; David H Berger; Daniel Albo; Liz Lee; Anu Subramanian; Charles F Bellows Journal: Am J Surg Date: 2008-11 Impact factor: 2.565
Authors: Margaret A Olsen; Katelin B Nickel; Anna E Wallace; Daniel Mines; Victoria J Fraser; David K Warren Journal: Infect Control Hosp Epidemiol Date: 2015-03 Impact factor: 3.254