Long-term follow-up results after open small umbilical hernia repairs


Authors: O. Malý 1,2;  O. Sotona 1
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice Hradec Králové, přednosta: Prof. MUDr. A. Ferko, CSc. 1;  Fakulta vojenského zdravotnictví Univerzity obrany v Brně, děkan: Doc. MUDr. J. Páral, Ph. D. 2
Published in: Rozhl. Chir., 2014, roč. 93, č. 4, s. 208-211.
Category: Original articles

Overview

Introduction:
Adult umbilical hernia is a common surgical condition in the fifth and sixth decade of life. Despite the high frequency of umbilical hernia repairs, disappointingly high recurrence rates after simple suture repairs are reported, amounting to 54%. In addition, it is reported that with the rising frequency of recurrences, the size of the hernial sac and gate gradually increases. Therefore we decided to find out the incidence of recurrences after operative repair of an umbilical hernia at our department.

Material and methods:
Patient data for this retrospective study focusing on the period between 2006 and 2010 were obtained from the electronic hospital database. Patients with umbilical hernia and the abdominal wall defect up to 3 cm who underwent primary elective procedure were included in the study. Patients with incisional hernias were excluded. All patients were contacted at least 3 years after operation to confirm the accuracy of data.

Results:
A total of 127 patients were included in this study. In the abovementioned period, no mesh was used during primary surgery in any of the patients. Recurrence occurred in a total of 13.4% of patients. Approximately 40% of patients with the first recurrence were re-operated at our department, 30% of patients were re-operated in other hospitals and the rest have not sought medical attention in respect of the recurrence. Patients with recurrence did not differ from the others as regards age, body mass index or surgical site infection development.

Conclusion:
Due to the high recurrence rates after operative sutures of the umbilical hernias there is a need to thoroughly consider the potential risk factors such as the body mass index and the abdominal wall defect size. Therefore, it is recommended to use the mesh more widely during primary surgery, especially in obese patients with BMI over 30 and the wall defect size exceeding 3 cm. The question remains whether to use the mesh in all overweight patients and with wall defect smaller than 3 cm.

Key words:
umbilical hernia – suture repair – Mayo repair – hernia recurrence – mesh


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Labels
Surgery Orthopaedics Trauma surgery
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