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Factors that affect recurrence after incisional herniorrhaphy with prosthetic material
A Rios1, J M Rodriguez, V Munitiz
1Departamento de Cirugía General y del Aparato Digestivo I, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.
Objective:
To evaluate the risk factors for recurrence after prosthetic incisional herniorrhaphy.
Design:
Retrospective study.
Setting:
Tertiary referral centre, Spain.
Patients:
246 patients who had incisional herniorrhaphy with a prosthetic material (polypropylene) between 1990 and 1997
Interventions:
A reinforcement mesh was inserted when the hernia was more than 5 cm. In incisional hernias less than 5 cm the reinforcement mesh was inserted when the repair was under tension or when tissues were noted to be weak during the operation.
Main Outcome Measures:
Age, sex, obesity, the presence of bronchial disease, previous repair of the incisional hernia, type of surgery, size and site of hernia and presence of local complications during the immediate postoperative period.
Results:
Mean (SD) follow-up was 77 (6) months (minimum follow up two years). The hernia recurred in 43 cases (17%) (mean time of recurrence 10 (8) months). Age over 60 years, previous herniorrhaphy, size of hernia, and postoperative local complications were significant risk factors (p < 0.01) in both the univariate and multivariate analyses.
Conclusions:
Patients at the greater risk of recurrence are those aged over 60 years, with large, recurrent hernias and who develop local complications during the postoperative period.