A Winsnes1, M M Haapamäki2, U Gunnarsson2, K Strigård2. 1. Department of Surgical and Perioperative Sciences, Umeå University and University Hospital of Umeå, 901 85, Umeå, Sweden. annika.winsnes@umu.se. 2. Department of Surgical and Perioperative Sciences, Umeå University and University Hospital of Umeå, 901 85, Umeå, Sweden.
Abstract
PURPOSE: To compare recurrence and surgical complications following two dominating techniques: the use of suture and mesh in umbilical hernia repair. METHODS: 379 consecutive umbilical hernia repair procedures performed between 1 January 2005 and 14 March 2014 in a university setting were included. Gathering was made using International Classification of Diseases codes for both procedure and diagnosis. Each patient record was scrutinized with respect to 45 variables, and the results entered in a database. RESULTS: Exclusion <18 years-of-age (32), non-primary umbilical hernia (25), wrong diagnosis (7), concomitant major abdominal surgery (5), double registration (3) and pregnancy (1) left 306 patients eligible for analysis. Gender distribution was 97 women and 209 men. There was no difference between mesh and suture with regard to the primary outcome variable, cumulative recurrence rate, 8.4 %. Recurrence was both self-reported and found on clinical revisit and defined as recurrence when verified by a clinician and/or radiologist. Results presented as odds ratio (OR) with 95 % confidence interval (CI) show a significantly higher risk for recurrence in patients with a coexisting hernia OR 2.84, 95 % CI 1.24-6.48. Secondary outcome, postoperative surgical complication (n = 51 occurrences), included an array of postoperative surgical events commencing within 30 days after surgery. Complication rate was significantly higher in patients receiving mesh repair OR 6.63, 95 % CI 2.29-20.38. CONCLUSIONS: Suture repair decreases the risk for surgical complications, especially infection without an increase in recurrence rate. The risk for recurrence is increased in patients with a history of another hernia.
PURPOSE: To compare recurrence and surgical complications following two dominating techniques: the use of suture and mesh in umbilical hernia repair. METHODS: 379 consecutive umbilical hernia repair procedures performed between 1 January 2005 and 14 March 2014 in a university setting were included. Gathering was made using International Classification of Diseases codes for both procedure and diagnosis. Each patient record was scrutinized with respect to 45 variables, and the results entered in a database. RESULTS: Exclusion <18 years-of-age (32), non-primary umbilical hernia (25), wrong diagnosis (7), concomitant major abdominal surgery (5), double registration (3) and pregnancy (1) left 306 patients eligible for analysis. Gender distribution was 97 women and 209 men. There was no difference between mesh and suture with regard to the primary outcome variable, cumulative recurrence rate, 8.4 %. Recurrence was both self-reported and found on clinical revisit and defined as recurrence when verified by a clinician and/or radiologist. Results presented as odds ratio (OR) with 95 % confidence interval (CI) show a significantly higher risk for recurrence in patients with a coexisting hernia OR 2.84, 95 % CI 1.24-6.48. Secondary outcome, postoperative surgical complication (n = 51 occurrences), included an array of postoperative surgical events commencing within 30 days after surgery. Complication rate was significantly higher in patients receiving mesh repair OR 6.63, 95 % CI 2.29-20.38. CONCLUSIONS: Suture repair decreases the risk for surgical complications, especially infection without an increase in recurrence rate. The risk for recurrence is increased in patients with a history of another hernia.
Authors: Paul D Colavita; Igor Belyansky; Amanda L Walters; Alla Y Zemlyak; Amy E Lincourt; B Todd Heniford; Vedra A Augenstein Journal: Am J Surg Date: 2014-04-03 Impact factor: 2.565
Authors: Mette W Christoffersen; Frederik Helgstrand; Jacob Rosenberg; Henrik Kehlet; Pernille Strandfelt; Thue Bisgaard Journal: Am J Surg Date: 2014-07-31 Impact factor: 2.565
Authors: F E Muysoms; M Miserez; F Berrevoet; G Campanelli; G G Champault; E Chelala; U A Dietz; H H Eker; I El Nakadi; P Hauters; M Hidalgo Pascual; A Hoeferlin; U Klinge; A Montgomery; R K J Simmermacher; M P Simons; M Smietański; C Sommeling; T Tollens; T Vierendeels; A Kingsnorth Journal: Hernia Date: 2009-06-03 Impact factor: 4.739
Authors: J E H Ponten; B J M Leenders; W K G Leclercq; T Lettinga; J Heemskerk; J L M Konsten; P S S Castelijns; S W Nienhuijs Journal: World J Surg Date: 2018-05 Impact factor: 3.352
Authors: S G Parker; S Halligan; M Erotocritou; C P J Wood; R W Boulton; A A O Plumb; A C J Windsor; S Mallett Journal: Hernia Date: 2019-05-31 Impact factor: 4.739