M Juvany1, C Hoyuela2, F Carvajal2, M Trias2, A Martrat2, J Ardid2. 1. Department of General and Digestive Surgery, Hospital Plató Barcelona, Universitat Autònoma Barcelona, Plató 21, 08006, Barcelona, Spain. mjuvanygomez@gmail.com. 2. Department of General and Digestive Surgery, Hospital Plató Barcelona, Universitat Autònoma Barcelona, Plató 21, 08006, Barcelona, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: The recurrence rate of incisional hernia (IH) repair is usually underestimated due to a lack of long-term follow-up. The objective of this study was to evaluate recurrence rate for patients operated on midline IH surgery, using a primary closure and prosthetic onlay technique, 5 years after the procedure. MATERIALS AND METHODS: From January 2009 to January 2011, all 92 patients operated on elective midline IH repair by primary closure and prosthetic onlay technique in a General Surgery Department were retrospectively included in the study. Exclusion criteria were absence of follow-up or death. Recurrence rate and quality of life were assessed. Demographic, surgical data and quality of life in patients with and without 5-year recurrence were compared. RESULTS: Mean follow-up was 64 months. Ultimately, 76 patients were included in the study, representing 82% of the selected patients during the study period (76/92), of whom 24 presented a recurrence (32%). Half (12) were diagnosed for recurrence more than 3 years after the surgery. Patients who developed a recurrence had more percentage of obesity (64 vs. 29%, p = 0.016), which denoted an odds ratio (OR) for recurrence of 4.4 (1.2-15.7; p = 0.01) and they punctuated lower in quality of life (6.0 ± 2.9 vs. 7.6 ± 2.6, p = 0.006). CONCLUSIONS: Recurrence rate on midline IH repair is still a concern (32% at 5 years). It is advisable to look for other strategies and more efficient surgical techniques for IH surgery, especially in obese patients.
INTRODUCTION AND OBJECTIVES: The recurrence rate of incisional hernia (IH) repair is usually underestimated due to a lack of long-term follow-up. The objective of this study was to evaluate recurrence rate for patients operated on midline IH surgery, using a primary closure and prosthetic onlay technique, 5 years after the procedure. MATERIALS AND METHODS: From January 2009 to January 2011, all 92 patients operated on elective midline IH repair by primary closure and prosthetic onlay technique in a General Surgery Department were retrospectively included in the study. Exclusion criteria were absence of follow-up or death. Recurrence rate and quality of life were assessed. Demographic, surgical data and quality of life in patients with and without 5-year recurrence were compared. RESULTS: Mean follow-up was 64 months. Ultimately, 76 patients were included in the study, representing 82% of the selected patients during the study period (76/92), of whom 24 presented a recurrence (32%). Half (12) were diagnosed for recurrence more than 3 years after the surgery. Patients who developed a recurrence had more percentage of obesity (64 vs. 29%, p = 0.016), which denoted an odds ratio (OR) for recurrence of 4.4 (1.2-15.7; p = 0.01) and they punctuated lower in quality of life (6.0 ± 2.9 vs. 7.6 ± 2.6, p = 0.006). CONCLUSIONS: Recurrence rate on midline IH repair is still a concern (32% at 5 years). It is advisable to look for other strategies and more efficient surgical techniques for IH surgery, especially in obesepatients.
Entities:
Keywords:
Incisional hernia; Obesity; Quality of life; Recurrent hernia
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