F Köckerling1, H Hoffmann2, D Adolf3, W Reinpold4, P Kirchhoff2, F Mayer5, D Weyhe6, B Lammers7, K Emmanuel5. 1. Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany. ferdinand.koeckerling@vivantes.de. 2. Two Surgeons-Center for Hernia Surgery and Proctology, St. Johanns-Vorstadt 44, 4056, Basel, Switzerland. 3. StatConsult GmbH, Halberstädter Strasse 40 a, 39112, Magdeburg, Germany. 4. Department of Surgery, Wilhelmsburger Hospital Gross Sand, Academic Teaching Hospital of University Hamburg, Gross Sand 3, 21107, Hamburg, Germany. 5. Department of Surgery, Paracelsus Medical University Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria. 6. Department of General and Visceral Surgery, Pius Hospital, University Hospital of Visceral Surgery, Georgstrasse 12, 26121, Oldenburg, Germany. 7. Department of Surgery I-Section Coloproctology and Hernia Surgery, Lukas Hospital, Preussenstrasse 84, 41464, Neuss, Germany.
Abstract
INTRODUCTION: Due to the paucity of randomized controlled trials, meta-analyses of incisional hernia repair can hardly give any insights into the influence factors on the various outcome criteria. Therefore, a multivariable analysis of data from the Herniamed Registry was undertaken with the aim to define potential influencing factors for the outcome. METHODS: Multivariable analysis of the data available for 22,895 patients with primary elective incisional hernia repair was performed to assess the confirmatory predefined potential influence factors and their association with the perioperative and 1-year follow-up outcomes. A model validation procedure was implemented using a bootstrap algorithm in order to account for the robustness of results. RESULTS: Higher European Hernia Society (EHS) width classification, open procedure, female gender, and preoperative pain have a highly significant association with an unfavorable outcome in incisional hernia repair. Larger defect width and open operation have a highly significantly unfavorable relation to the postoperative surgical complications, general complications, and the complication-related reoperations, while female gender and preoperative pain have a highly significantly unfavorable association with the rates of pain at rest, pain on exertion, and chronic pain requiring treatment at 1-year follow-up. The recurrence rate is significantly unfavorably influenced by higher EHS width classification, higher BMI, and lateral EHS classification. CONCLUSION: Higher EHS width classification, open procedure, female gender, higher BMI, and lateral EHS classification, as well as preoperative pain are the most important unfavorable influencing factors associated with a worse outcome in incisional hernia repair.
INTRODUCTION: Due to the paucity of randomized controlled trials, meta-analyses of incisional hernia repair can hardly give any insights into the influence factors on the various outcome criteria. Therefore, a multivariable analysis of data from the Herniamed Registry was undertaken with the aim to define potential influencing factors for the outcome. METHODS: Multivariable analysis of the data available for 22,895 patients with primary elective incisional hernia repair was performed to assess the confirmatory predefined potential influence factors and their association with the perioperative and 1-year follow-up outcomes. A model validation procedure was implemented using a bootstrap algorithm in order to account for the robustness of results. RESULTS: Higher European Hernia Society (EHS) width classification, open procedure, female gender, and preoperative pain have a highly significant association with an unfavorable outcome in incisional hernia repair. Larger defect width and open operation have a highly significantly unfavorable relation to the postoperative surgical complications, general complications, and the complication-related reoperations, while female gender and preoperative pain have a highly significantly unfavorable association with the rates of pain at rest, pain on exertion, and chronic pain requiring treatment at 1-year follow-up. The recurrence rate is significantly unfavorably influenced by higher EHS width classification, higher BMI, and lateral EHS classification. CONCLUSION: Higher EHS width classification, open procedure, female gender, higher BMI, and lateral EHS classification, as well as preoperative pain are the most important unfavorable influencing factors associated with a worse outcome in incisional hernia repair.
Authors: C Stabilini; G Cavallaro; P Dolce; S Capoccia Giovannini; F Corcione; M Frascio; M Sodo; G Merola; U Bracale Journal: Hernia Date: 2019-09-23 Impact factor: 4.739
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Authors: K K Jensen; B East; B Jisova; M López Cano; G Cavallaro; L N Jørgensen; V Rodrigues; C Stabilini; D Wouters; F Berrevoet Journal: Hernia Date: 2022-02-25 Impact factor: 2.920