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Published on: September 22, 2023
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Long-term reoperation rate following primary ventral hernia repair: a register-based study
A Katawazai1,2,3, G Wallin4,5, G Sandblom6,7
1Departments of Surgery, School of Medical Sciences, Örebro University Hospital, Örebro University, Stockholm, Sweden. asmatullah.katawazai@regionorebrolan.se.
Summary
Open mesh repair significantly reduces reoperation rates for ventral hernias compared to suture or laparoscopic methods. Factors like young age, female sex, and liver cirrhosis increase reoperation risk.
Area of Science:
- Hernia Surgery
- Surgical Outcomes
- Abdominal Wall Reconstruction
Background:
- Ventral hernia repair is a common surgical procedure.
- Reoperation after primary repair indicates treatment failure or recurrence.
- Identifying risk factors for reoperation is crucial for improving patient outcomes.
Purpose of the Study:
- To analyze the risk of reoperation following primary ventral hernia repair.
- To compare reoperation rates across different surgical techniques for umbilical and epigastric hernias.
- To identify patient-specific risk factors associated with hernia reoperation.
Main Methods:
- Retrospective analysis of population-based data from the Swedish National Patient Register (NPR) between 2010-2019.
- Inclusion of primary umbilical and epigastric hernia repairs, with reoperation defined as repeat repair.
- Multivariable Cox proportional hazard analysis to assess the impact of surgical technique and patient factors on reoperation risk.
Main Results:
- Over 29,000 umbilical and 6,500 epigastric hernia repairs were analyzed.
- Open mesh repairs (onlay, interstitial, sublay) showed significantly lower reoperation rates compared to open suture repair.
- Laparoscopic repair did not show a significant difference in reoperation rates compared to open suture repair.
- Younger age (<50 years), female sex, and liver cirrhosis were identified as significant risk factors for reoperation in umbilical hernia repair.
- Younger age (<50 years) was the primary risk factor for reoperation in epigastric hernia repair.
Conclusions:
- All open mesh repair techniques are associated with reduced reoperation rates compared to open suture repair and laparoscopic repair.
- Female sex, younger age, and liver cirrhosis are independent risk factors for reoperation due to hernia recurrence.
- These findings emphasize the benefit of mesh in reducing ventral hernia reoperations and highlight patient factors influencing recurrence risk.
