Predictors for recurrence after open umbilical hernia repair in 979 patients

Our study aims were to evaluate factors that predict recurrence after open umbilical hernia repair with either mesh or primary closure.

Consecutive patients (n = 1,125) undergoing open umbilical hernia repair from 2009 to 2018 were identified from a prospectively managed, quality database. Kaplan-Meier curves and log-rank tests were used to analyze recurrence-free survival for preoperative, intraoperative, and postoperative factors. Univariable and multivariable Cox regression was used to analyze recurrence-free survival by age, sex, body mass index, concurrent laparoscopic inguinal hernia repair, smoking status, diabetes, postoperative infection, hernia size in greatest dimension, and type of repair.

The overall recurrence rate was 3.3% with a median follow-up of 14 months. Univariable analysis revealed a difference in recurrence-free survival for current smoking (P = .039), diabetes (P = .007), higher body mass index (P = .057), and postoperative infection (P < .001). Multivariable analysis indicated higher body mass index (P = .007), concurrent laparoscopic inguinal hernia repair (P = .044), current smoking status (P = .020), diabetes (P = .021), and a primary closure repair of hernias ≥1.5 cm (P = .001) had a greater risk of recurrence. Postoperative infection showed an association with recurrence (P = .053).

Our results indicate higher body mass index, concurrent laparoscopic inguinal hernia repair, current smoking, diabetes, primary closure repair of hernias ≥1.5 cm, and postoperative infection were associated with a greater risk of recurrence after open umbilical hernia repair.