The Cost of Recurrence: Long-Term Outcomes After Recurrent Ventral Hernia Repair

Most hernia recurrence literature records follow-up periods from one to five years and focus on hernia recurrence. More recent data suggest many ventral hernia repairs have long-term consequences related not only to hernia recurrence but also reoperation and mesh-related complications. The purpose of this project was to evaluate long-term outcomes of ventral hernia repair and compare outcomes between non-recurrent and recurrent hernias repairs. An IRB approved retrospective review of consecutive patients undergoing ventral hernia repair from August 2008 to July 2014 from a prospectively collected database was performed to allow for long-term follow-up. Demographic and surgical characteristics were recorded as well as short-term outcomes. Long-term outcomes including recurrences, mesh-related complications, and hernia reoperation were obtained by retrospective chart review. Recurrence was defined as documentation of a hernia by physical exam or CT imaging. A total of 200 patients were included. The median follow-up was 4322 [2959, 4787] days. Mesh-related complications occurred in 9%, recurrence 21%, and reoperation 19%. In comparing non-recurrent to recurrent hernia repairs, recurrent hernia repairs had a higher rate of mesh complications mesh complications (2.0% vs 16.0% (P < 0.001)), hernia recurrence (16.0% vs 42.0% (P < 0.001)), and reoperation rate (9.0% vs 29.0% (P < 0.001)) Long-term outcomes associated with ventral hernia repair are less than ideal with a high rate of recurrence, reoperation, and mesh-related complications. Recurrent hernia repair was shown to have worse long-term outcomes compared to primary hernias and represent a high clinical burden to surgeon and patient.