Factors Affecting Recurrence following Incisional Herniorrhaphy

Abstract

The purpose of this study was to determine the influence of chronic illness, obesity, and type of repair on the likelihood of recurrence following incisional herniorrhaphy. The medical records of 77 patients who underwent elective repair of a midline incisional hernia at the Dallas Veterans Affairs Medical Center between 1991 and 1995 were reviewed. Demographic data, presence of chronic illnesses, type of repair, and presence of recurrence were noted. Ninety-six percent of the patients were men, with an average age of 59 years. More than 50% of the patients had chronic lung or cardiac diseases and more than 40% weighed > or = 120% of their ideal body weight and had a body mass index (BMI) > or = 30. Sixty-two percent of the patients underwent primary reapproximation of the fascia (tissue repair), whereas 38% underwent repair with prosthetic material (prosthetic repair). The overall recurrence rate was 45%, with a median follow-up of 45 months (range 6-73). Seventy-four percent of the recurrences presented within 3 years of repair. The recurrence rate for those patients undergoing a tissue repair was 54%, whereas the recurrence rate following prosthetic repair was 29%. The incidence of recurrence for patients with pulmonary or cardiac disease or diabetes mellitus was similar to that of patients without these illnesses. The percent ideal body weight and BMI of patients who developed a recurrent hernia, particularly following a prosthetic repair, were significantly greater than those of patients whose repairs remained intact. These data strongly support the use of prosthetic repairs for incisional hernias, particularly in patients who are overweight.

Clinical study and management of incisional hernias: a prospective monocenter experience

“…7 The postulated predisposing factors for incisional hernia are obesity, diabetes mellitus, steroids, smoking, sub-optimal surgical technique, old age, malnutrition, multiple laparotomies, chronic pulmonary disease, type of incision and closure including suture material used and the most important wound infection. 8 Despite the increasing progress of modern surgery, the optimum surgical The introduction of prosthetic mesh revolutionised the treatment of groin hernia but, to date, has had little impact on the treatment of incisional hernia. 10 The present study entitled is undertaken to assess the magnitude of problem, analyse various factors leading to development of this condition and different modalities of treatment practiced, postoperative complications and their management, various factors affecting surgical outcome in these patients.…”

Long-term Follow-up of a Randomized Controlled Trial of Suture Versus Mesh Repair of Incisional Hernia

“…Suture repair of incisional hernia results in recurrence rates of 12% to 54%, 10 -16 while mesh repair results in recurrence rates of 2% to 36%. [13][14][15][17][18][19][20][21][22][23] Because most studies only provide shortterm follow-up, these recurrence rates may even be underestimated. In addition to the high recurrence rates, incisional hernia repair may give rise to serious complications, such as enterocutaneous fistula and bowel obstruction, causing deterioration rather than improvement of the patient's situation.…”

A study to assess factors contributing for the occurrence of incisional hernia among patients operated with pfannenstiel incision and management with mesh repair

“…The present study findings were consistent with other studies too were they have used Polypropylene mesh for repair and they too got results. [15][16][17][18] The present study shows that out of 25 study participants who were having incisional hernia, 8% were asymptomatic that is incisional hernia was found after physical examination. Near about 20% of them had pain as presenting symptom and 72% had swelling.…”