Predictors for recurrence after open umbilical hernia repair in 979 patients.
Adult
Aged
Databases, Factual
Female
Follow-Up Studies
Hernia, Umbilical
/ diagnosis
Herniorrhaphy
/ adverse effects
Humans
Kaplan-Meier Estimate
Laparotomy
/ methods
Male
Middle Aged
Multivariate Analysis
Postoperative Complications
/ epidemiology
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Assessment
Severity of Illness Index
Surgical Mesh
Treatment Outcome
Wound Closure Techniques
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
16
02
2019
revised:
08
04
2019
accepted:
16
04
2019
pubmed:
11
8
2019
medline:
28
1
2020
entrez:
11
8
2019
Statut:
ppublish
Résumé
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.
Sections du résumé
BACKGROUND
Our study aims were to evaluate factors that predict recurrence after open umbilical hernia repair with either mesh or primary closure.
METHODS
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.
RESULTS
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).
CONCLUSION
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.
Identifiants
pubmed: 31399219
pii: S0039-6060(19)30315-0
doi: 10.1016/j.surg.2019.04.040
pii:
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
615-622Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.