Long-term follow-up results of umbilical hernia repair.

Abstract

IntroductionMultiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery.AimTo compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence.Material and methodsA retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed.ResultsOne hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias (< 2 cm) had a recurrence in the suture repair group. Logistic regression analysis showed that body mass index (BMI) > 30 kg/m2, diabetes and wound infection were independent risk factors for umbilical hernia recurrence.ConclusionsThe overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m2, diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

Mesh versus suture in elective repair of umbilical hernia: systematic review and meta-analysis

“…One study invited surgeons to specific pretrial training sessions. A longer duration of surgery for mesh compared with suture repair was reported by five studies, and four reported administration of preoperative antibiotics in all patients.…”

“…After initial screening of titles and abstracts, 42 studies were assessed for inclusion eligibility. In total, 14 studies were included, comprising six RCTs, one prospective cohort study and seven retrospective cohort studies, involving a total of 2361 patients. Characteristics of the included studies are shown in Table .…”

“…Follow‐up was assessed by clinical examination in all RCTs, and by the last clinical examination noted in medical records in all cohort studies. In some studies, additional follow‐up was accomplished by questionnaires sent to patients to identify recurrence, long‐term infection and pain, or by telephone contact to identify chronic pain. In three cohort studies, patients received an invitation for an extra physical examination.…”

“…In some studies, additional follow‐up was accomplished by questionnaires sent to patients to identify recurrence, long‐term infection and pain, or by telephone contact to identify chronic pain. In three cohort studies, patients received an invitation for an extra physical examination. Evidence of recurrence was based on physical examination, imaging (ultrasonography or CT) or reoperation.…”

“…The relative complexity and prolonged duration of surgery associated with the use of mesh for repair of smaller umbilical hernias may explain this discrepancy between research findings and surgeons' choice of repair. It has also been suggested that mesh is related to an increased risk of complications, including surgical‐site infection (SSI), seroma, haematoma and chronic pain. It is unclear whether these complications could offset the benefits of mesh repair compared with sutures alone.…”