Hernia recurrence after primary repair of small umbilical hernia defects.
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
received:
29
07
2022
accepted:
13
09
2022
pubmed:
2
10
2022
medline:
15
12
2022
entrez:
1
10
2022
Statut:
ppublish
Résumé
An evidence-based approach to the repair of umbilical hernias (UH)<1 cm has yet to be defined. A prospectively maintained, institutional hernia database was queried for patients undergoing primary suture repair of UH ≤ 1 cm. The primary outcome was recurrence and secondary outcomes were wound complications. Of 332 patients included (226-primary, 106-incisional), recurrence was identified in 4 (1.8%) primary versus 8 (7.5%) incisional-UH (p = 0.022), with follow-up of 4.7 ± 4.4 years. There were 10 (3.0%) wound complications: 4 (1.2%) superficial wound infections, 1 (0.3%) superficial wound dehiscence, and 5 (1.5%) seromas. On multivariable analysis of recurrence, incisional-UH had an odds ratio of 4.2 compared to primary. Suture choice, diabetes, BMI, tobacco-use history, and wound complications were not significant. With long term follow-up, recurrence after primary suture repair of UH ≤ 1 cm occurred in 1.8% of primary and 7.5% of incisional UH. On multivariable analysis, incisional-UH increased recurrence odds by 4.2 times compared to primary.
Sections du résumé
BACKGROUND
BACKGROUND
An evidence-based approach to the repair of umbilical hernias (UH)<1 cm has yet to be defined.
METHODS
METHODS
A prospectively maintained, institutional hernia database was queried for patients undergoing primary suture repair of UH ≤ 1 cm. The primary outcome was recurrence and secondary outcomes were wound complications.
RESULTS
RESULTS
Of 332 patients included (226-primary, 106-incisional), recurrence was identified in 4 (1.8%) primary versus 8 (7.5%) incisional-UH (p = 0.022), with follow-up of 4.7 ± 4.4 years. There were 10 (3.0%) wound complications: 4 (1.2%) superficial wound infections, 1 (0.3%) superficial wound dehiscence, and 5 (1.5%) seromas. On multivariable analysis of recurrence, incisional-UH had an odds ratio of 4.2 compared to primary. Suture choice, diabetes, BMI, tobacco-use history, and wound complications were not significant.
CONCLUSIONS
CONCLUSIONS
With long term follow-up, recurrence after primary suture repair of UH ≤ 1 cm occurred in 1.8% of primary and 7.5% of incisional UH. On multivariable analysis, incisional-UH increased recurrence odds by 4.2 times compared to primary.
Identifiants
pubmed: 36182599
pii: S0002-9610(22)00566-9
doi: 10.1016/j.amjsurg.2022.09.019
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1357-1361Informations de copyright
Copyright © 2022. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Declaration of competing interest Dr. Colavita has an investigator sponsored agreement with Medtronic. Dr. Augenstein receives speaking honoraria from Medtronic, Allergan, Intuitive, Acelity, and Bard. Dr. Heniford receives surgical research/education grants as well as honoraria for speaking from Allergan and W.L. Gore. Dr. Katzen, Dr. Sacco, Mr. Ku, and Mr. Scarola have no conflicts of interest or financial ties to disclosures. No external funding was received to support this study.