Predictors for recurrence after open umbilical hernia repair in 979 patients

Donovan, Kara; Denham, Merritt; Kuchta, Kristine; Denham, Woody; Linn, John G.; Haggerty, Stephen P.; Carbray, JoAnn; Ujiki, Michael

doi:10.1016/j.surg.2019.04.040

Cited by 24 publications

(30 citation statements)

References 24 publications

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“…This is also consistent with the results obtained by other researchers. Thus, K. Donovan et al found that the umbilical hernia recurrence rate after open mesh or suture hernia repair amounted to 3.3% [13]. According to M.W.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Operations During Umbilical and Paraumbilical Hernia Repair: Possible or Necessary?

et al. 2021

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The aim of the study was to determine the possibility and effectiveness of simultaneous surgical interventions in umbilical and paraumbilical hernia repair. Material and methods: 148 case histories were analyzed concerning patients who were routinely admitted to the surgical department of the Kharkiv Regional Council’s Municipal Non-Profit Enterprise «Regional Clinical Hospital» between 2017 and 2019, and who underwent umbilical and paraumbilical hernia repair simultaneously with operations related to some other surgical pathology (group 1, n = 67) or in separate interventions (group 2, n = 81). All patients were routinely operated after a set of mandatory and additional general clinical, laboratory and instrumental research conducted in accordance with the existing guidelines. The structure and results of surgical interventions related to the underlying disease and simultaneous operations were studied. Results: Simultaneous operations were performed for comorbid cholecystolithiasis, diaphragmatic esophageal hernia with gastroesophageal reflux, inguinal hernia, white line hernia, benign diseases of the uterus and uterine appendages et al. The frequency of complications and recurrences of hernia in patients with simultaneous and isolated of umbilical hernia repair did not differ significantly. The outcome of the operation mostly depended on the method of operation (postoperative complications were most often observed in open sutures repair and were absent in laparoscopic hernia repair). Additional risk factors were weight gain and diabetes. Conclusions: Summarizing the data obtained, it can be concluded that application of modern endovideoscopic techniques in surgery makes simultaneous surgical interventions not only possible but also necessary in the presence of concomitant abdominal pathology that requires surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Simultaneous Operations During Umbilical and Paraumbilical Hernia Repair: Possible or Necessary?

et al. 2021

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“…Defect size may influence the outcome of umbilical hernia repair. Predictors of recurrence are smoking, diabetes, concomitant laparoscopic inguinal hernia repair and infection but not mesh type [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Holzheimer¹,

Gaschütz

2020

Journal of Surgical Case Reports

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Reports on the ambulatory open repair of umbilical trocal hernias are missing. Patients with trocar, primary and recurrent umbilical hernia open suture and open suture–mesh repair with prospective follow-up were retrospectively evaluated. Patients received perioperative antibiotic prophylaxis, preemptive analgesia and modified anesthesia. In total, 171 patients with umbilical hernia (51 years, female 14%; male 86%) were treated with open suture (n = 29; 17%) and suture–mesh (n = 142; 83%) repair. In total, 10% of patients were treated for trocar hernia (late onset), 5% for recurrent hernia and 85% for a primary umbilical hernia. In total, 29% of trocar hernia repairs had minor complications associated with obesity (40%) and comorbidity (80%). Age, suture and suture–mesh repair were not associated with complications. According to guidelines for umbilical hernia repair open flat mesh may be useful in the treatment of trocar hernia.

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“…Overall, 20 studies were included which made explicit recommendations for mesh placement based on UH size (Table 1). Most studies were retrospective institutional analyses including multiple surgeons and techniques for both open and mesh repair 6,10,[15][16][17][19][20][21][22][23][24][25][26] ; one study was a single-center single-surgeon experience 5 ; one study was a retrospective analysis of the American Hernia Society Quality Collaborative 27 ; one was a multicenter international randomized controlled trial 28 ; one was a single-center randomized trial focusing on incision technique in open UH repair 29 ; one was a systematic review of the literature 30 ; one was a consensus statement informed by systematic review for ventral hernia repairs 31 ; and one was review of the literature with consensus statements of guidelines for UHR. 18 There was a variety of umbilical hernia defect sizes to recommend placement of mesh.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…4 However, tissue repair is still commonly performed for primary UHs in many centers with experience in the technique. [5][6][7][8][9][10] Primary tissue repair reduces the risk of surgical site infections (SSIs); if an infection does occur, it is more readily managed than a mesh repair SSI. 11,12 Albeit rare, other more serious complications have been reported following mesh repair of UH related to migration of the mesh into surrounding organs.…”

Section: Introductionmentioning

confidence: 99%

“…14 Open tissue repair for UHs has shown acceptable recurrence rates in large patient cohorts. 5,6,10,[15][16][17] In veteran patients, it has also yielded low recurrence rates. 7,8 A specific hernia defect size that would prohibit primary tissue repair has been previously investigated, but studies are largely heterogenous in repair type (tissue or mesh), and multiple techniques are used by various surgeons.…”

Section: Introductionmentioning

confidence: 99%

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Hernia Size and Mesh Placement in Primary Umbilical Hernia Repair

Tao

Ordonez

Huerta

2020

The American Surgeon™

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Introduction Umbilical hernia repair (UHR) using mesh has been demonstrated to significantly reduce recurrence. However, many surgical centers still perform tissue repair for UH. In the present study, we assessed a cohort of veteran patients undergoing a standard open tissue repair for primary UH to determine at which size recurrence may preclude tissue repair. A systematic review of the literature on hernia size recommendations to guide mesh placement was performed. Methods A single-institution single-surgeon retrospective review of all patients undergoing open tissue repair of primary UH (n = 344) was undertaken at the VA North Texas Health Care System between 2005 and 2019. Guidelines for the preferred reporting items for systematic reviews and meta-analysis were undertaken for systematic review. Results A literature review yielded inconsistent guidance for a specific hernia size to proceed with tissue vs. mesh repair. Our institutional review yielded 17 (4.9%) recurrences. Univariable analysis demonstrated recurrence to be associated with hernia size (2.8 vs. 2.3 cm; P = .04). However, on multivariable analysis, hernia size was demonstrated as not an independent predictor of recurrence [OR 1.47 (95% CI; .97-2.21; P = .07)]. Conclusion A review of the literature suggests mesh placement most commonly when the hernia size is > 2.0 cm; however, sources of evidence are heterogeneous in study design, patient population, and hernia types studied. Our institutional review demonstrated that primary UHs < 2.3 cm can successfully be treated via tissue repair. Larger, recurrent, incisional, and primary epigastric hernias may benefit from mesh placement.

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Predictors for recurrence after open umbilical hernia repair in 979 patients

Cited by 24 publications

References 24 publications

Simultaneous Operations During Umbilical and Paraumbilical Hernia Repair: Possible or Necessary?

Simultaneous Operations During Umbilical and Paraumbilical Hernia Repair: Possible or Necessary?

Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Hernia Size and Mesh Placement in Primary Umbilical Hernia Repair

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