Abdominal wall incisional hernia repair improves respiratory function: results after 3 years of follow-up

Hernias severely impact patient quality of life (QoL), and 80% of patients require a surgical operation. Moreover, hernias are responsible for respiratory function alterations. This study aims to investigate the postoperative alterations in respiratory function after open ventral hernia repair in patients with incisional hernia.

Patients operated on at the Policlinico "Paolo Giaccone" at Palermo University Hospital between January 2015 and December 2016 were identified in a prospective database. Fifty-one patients were enrolled in the study. The respiratory outcome measures used were forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF) and PEF percentage (%PEF). The timepoints at which the parameters listed were assessed were t₀, 1 week before the surgical operation; t₁, 12 months later; and t₂, 3 years later.

The difference between mean preoperative and postoperative PEF was significant [t₀ 4.32 (4.03-7.92), t₁ 6.7 (4.27-8.24) with p = 0.012 and t₂ 6.5 (4.25-8.21) with p = 0.026]. The %PEF increased from 75% preoperatively to 87% at t₁ (p = 0.009) and to 85% at t₂ (p = 0.03). No differences were found in the comparison of pre- and postoperative FVC, FEV1 or FEV1/FVC ratio.

The improvement in respiratory measures suggests the importance of abdominal wall restoration to recover functional activity of respiratory function.