Background: Recurrence rates after ventral hernia repair vary widely and evidence about risk factors for recurrence are conflicting. There is little evidence for risk factors for long-term recurrence.
Methods: Patients who underwent ventral hernia repair at our institution and were captured in the American College of Surgeons-National Surgical Quality Improvement Program database between 2002 and 2015 were included. We reviewed all demographic, procedural, and hernia-specific data.
Results: Six hundred and thirty patients were included for analysis with a median follow-up of 4.9 years (inter-quartile range, 2-7.3 years). By univariate analysis, index hernia repairs were more likely to recur if defect size was ≥4 cm (P = .019), no mesh was used (P = .026), or if the repair was for a recurrent hernia (P = .001). Five-year cumulative incidence of recurrence and reoperation was 24.3% and 16.0%, respectively. Patients with a perioperative surgical site occurrence, which included superficial, deep-incisional, and organ space surgical site infections as well as wound disruption, had a 5-year cumulative incidence of recurrence of 54.9% compared with 22.6% for those without surgical site occurrence. By multivariable analysis, non-primary hernia repair (hazard ratio 1.7, 95% confidence interval 1.2-2.4, P = .005) and any postoperative surgical site occurrence (hazard ratio 1.9, 95% confidence interval 1.1-3.6, P = .02) were the only risk factors predictive of recurrence. Patient body mass index had no independent effect on recurrence.
Conclusion: 1 in 4 patients undergoing an open ventral hernia repair will have a recurrence after 5 years, and this risk is doubled among patients who experience any perioperative surgical site occurrence. After controlling for patient comorbidities, including body mass index, hernia size, and mesh position, the most significant risk factor for recurrence after ventral hernia repair was a non-primary hernia and surgical site occurrence.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186954 | PMC |
| http://dx.doi.org/10.1016/j.surg.2020.01.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Short-term outcomes of low anterior resection with and without ileostomy for low, mid and upper rectal cancers.
Updates Surg
January 2025
The Surgery Group of Los Angeles, 8635 W 3Rd St, Suite 880, Los Angeles, CA, 90048, USA.
Although the addition of an ileostomy to low anterior resection (LAR) may often be considered preventative of anastomotic leakage (AL), evidence that clearly demonstrates such benefit is lacking. This study aimed to identify the impact of adding an ileostomy upon AL and organ-space surgical site infection (SSI) rates in patients with lower, middle, or upper rectal cancer. This case-control study included rectal cancer patients who had undergone elective LAR in the American College of Surgeons-National Surgical Quality Improvement Program dataset between 2016 and 2022.
View Article and Find Full Text PDFEvolution of sleep disordered breathing in infants with achondroplasia.
Sleep Breath
January 2025
McGovern Medical School University of Texas Health, Houston, TX, USA.
Purpose: Children with achondroplasia (ACH) are at risk for sudden death in infancy due to sleep disordered breathing (SDB) and foramen magnum stenosis (FMS). Sleep studies and neuroimaging are performed in infants with ACH, but interpretation of infant studies is challenging. We sought to describe baseline data on polysomnography (PSG) indices in infants with achondroplasia as well as effects of age and surgery on these parameters.
View Article and Find Full Text PDFThe learning curve for the Shouldice Repair: a pilot analysis of post-training specialized surgeons at the Shouldice Hospital.
Hernia
January 2025
Department of Surgery, Shouldice Hospital, Markham, ON, Canada.
Purpose: The aim of the study was to evaluate operative time and postoperative complications of 4 post-training specialized surgeons.
Methods: This was a pilot retrospective chart review to determine the learning curve of a Shouldice primary inguinal hernia repair (Shouldice Repair) of 4 post-training specialized surgeons, at the Shouldice Hospital. The first 300 Shouldice Repairs (early learning block) were compared to their 900-1,000 repairs as the primary operating surgeon (late learning block).
Predicting surgical site infections after open reduction and internal fixation for ankle fractures.
Arch Orthop Trauma Surg
January 2025
Trauma Unit, Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Introduction: Surgical site infections (SSI) are one of the more severe complications following ankle surgery. It is associated with worse outcomes and re-admissions. Therefore, identification of risk factors is essential.
View Article and Find Full Text PDFSpinal Epidural Hematoma Following Combined Spinal Epidural Anesthesia: A Case Report.
J Perianesth Nurs
January 2025
Department of Anesthesiology, Zhejiang Hospital, Hangzhou, Zhejiang, China. Electronic address:
A spinal epidural hematoma (SEH) is a rare complication of combined spinal epidural anesthesia. The case of a 55-year-old man who underwent orthopedic surgery under combined spinal epidural anesthesia is presented. Flurbiprofen and horse chestnut seed extract that potentially affect coagulation function during the perioperative period were used.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!