Long-Term Outcomes of Ventral Hernia Repair: An 11-Year Follow-Up

Abstract

Background: Ventral hernia repair (VHR) is one of the most common general surgery procedures; however, few studies with long-term follow-up of VHR outcomes exist. Methods: We performed a retrospective review of VHRs performed from 2000 to 2009 at a single institution. Our primary outcome was recurrence, and secondary outcomes were reoperations and complications including seroma, hematomas, abdominal wall abscess, wound infections, and mesh infections. Results: Our sample population (n=420; mean age 46.3±11.7 years) included 230 females (54.8%), and cases included laparoscopic (n=31; 7.5%), laparoscopic converted to open (n=7; 1.7%), and open (n=373, 90%). As compared to suture repairs, mesh repair was associated with lower rates of complications (25.7% vs 29.5%, p=0.10) and recurrence (12.8% vs 15.2%, p=0.67). Laparoscopic repairs had lower rates of complications than open repairs (25% vs 26.8%; p=0.70) but similar rates of recurrence (13.8% and 13.6%; p=0.53). After logistic regression, obesity, chronic obstructive pulmonary disease, component separation technique, and prolonged operating time (>75th percentile) were associated with increased complications. Conclusion: Obesity is a modifiable risk factor and must be addressed in patients undergoing VHRs. Mesh repair does not increase the risk of adverse long-term outcomes and may be performed safely in patients undergoing VHR.

Demographics and outcomes of ventral wall hernia repair at Sultan Qaboos University Hospital

“…11 The most common method of mesh application in for included participants was overlay followed by underly and that might be due to shorter operation time as it was mentioned in previous studies. 9 The most common complication post operatively was seroma in line with these findings a study of 1029 patients, found that the most common early post-operative complication was also seroma. 6 Finally, we demonstrated that most patients presented with abdominal swelling as the initial presentation which is consistent with a study that was conducted in Egypt.…”

“…Nevertheless, the analysis showed that the mean BMI of our study 32.3 kg/m 2 and hospital stay post operatively which was 3.5 days was approximately similar to the reported data internationally 27 kg/m 2 and a hospital stay of 3 days. 7,9 Also, the analysis of the included patients showed that there was significant correlation between age of patients and duration of admission, the younger the patient, the less hospital stay.…”

Classification of Adverse Events in Adult Surgery

“…Ultimately, the rate of treatment success is a crucial QI, which needs to be measured and reported, ideally in prospective registries adapted to the underlying disease. For example, for cancer the disease-free survival, 71 for abdominal wall surgeries the rate of recurrence, 72 for bariatric surgery the percentage-weight loss, 73 or for functional surgeries the relief of preoperative symptoms. 74 Due to the crucial role of adjuvant medical treatment and of technical innovation in cancer therapy and in organ transplantation, the optimal long-term outcomes in these fields do not entirely stem from surgical quality.…”

Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair

“…1 The prevalence of VHR continues to rise steadily, with approximately half a million procedures performed each year. 2 The introduction of prosthetic materials in the form of nonabsorbable synthetic meshes has led to a significant reduction in hernia recurrence rates compared with primary suture repair. 3,4 Synthetic meshes, typically composed of a polypropylene substrate, currently represent the standard of care for VHR.…”