Effect of Incisional Hernia Repair Technique on Subsequent Recurrent Herniation: A Retrospective Study

Inho Song1,2, Seung-Bum Ryoo2 and Kyu Joo Park2*

1Department of Surgery, Division of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Korea
2Department of Surgery, Seoul National University College of Medicine, Korea

^*Correspondance to: Kyu Joo Park 

 PDF  Full Text DOI: 10.25107/2474-1647.2839

Abstract

Purpose: This study aimed to evaluate the association between the method employed for Incisional Hernia (IH) repair and subsequent recurrence. Methods: The study cohort consisted of 324 consecutive patients who underwent IH repair from January 2004 to December 2014 at a single institution. We retrospectively analyzed pre- and perioperative data collated from all patients’ medical records. Totally, 44 (13.6%), 57 (17.6%), and 223 (68.8%) patients were classified into the simple suturing, partial mesh, and full mesh groups, respectively. The mean follow-up period was 39.4 (range, 0 to 259) months. Results: The overall incidence of recurrent incisional hernia was 9.9% (32/324). The two-year cumulative recurrent rates for simple suturing, partial mesh, and full mesh groups were 23%, 14%, and 6%, respectively. This study revealed that mesh application in incisional hernia repair surgery resulted in significantly lower cumulative recurrence rates than that observed with simple suturing. Mesh was applied either only on the hernial site (partial coverage) or overall the previously incised fascia (complete coverage). However, the recurrence rate did not differ significantly between patients who had received partial and total mesh coverage (log rank p=0.096). Factors such as age, sex, obesity, and number of previous abdominal surgeries did not influence incisional hernia recurrence. Adjusted analysis showed that mesh application was the only significant factor associated with IH recurrence. (Mesh, p<0.0001, full mesh group vs. simple suturing group, Exp(B) 2.418, 95% CI 1.397 to 4.182, p=0.002; full mesh group vs. partial mesh group, Exp(B) 0.970, 95% CI 0.529 to 1.776, p=0.921). Conclusion: This study demonstrates that mesh reinforcement during IH repair is an important technique for preventing recurrence. Future studies are indicated to determine the exact extent of mesh application in individual patients to prevent further complications.

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Cite the article

Song I, Ryoo S-B, Park KJ. Effect of Incisional Hernia Repair Technique on Subsequent Recurrent Herniation: A Retrospective Study. Clin Surg. 2020; 5: 2839..