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Long-term reoperation rate following primary ventral hernia repair: a register-based study
Örebro University, School of Medical Sciences. Departments of Surgery, School of Medical Sciences, Örebro University Hospital, Örebro University, Stockholm, Sweden; Örebro University Hospital, Faculty of Medicine and Health, Örebro University, Stockholm, Sweden; Department of Surgery, Karlskoga Hospital, Karlskoga, Sweden.ORCID iD: 0000-0002-3603-5606
Örebro University, School of Medical Sciences. Departments of Surgery, School of Medical Sciences, Örebro University Hospital, Örebro University, Stockholm, Sweden; Örebro University Hospital, Faculty of Medicine and Health, Örebro University, Stockholm, Sweden.
Department of Clinical Science and Education Södersjukhuset, Karolinska Institute, Stockholm, Sweden; Department of Surgery, Södersjukhuset, Stockholm, Sweden.
2022 (English)In: Hernia, ISSN 1265-4906, E-ISSN 1248-9204, Vol. 26, no 6, p. 1551-1559Article in journal (Refereed) Published
Abstract [en]

Background: The aim of this study was to analyse the risk for reoperation following primary ventral hernia repair.

Methods: The study was based on umbilical hernia and epigastric hernia repairs registered in the population-based Swedish National Patient Register (NPR) 2010-2019. Reoperation was defined as repeat repair after primary repair.

Results: Altogether 29,360 umbilical hernia repairs and 6514 epigastric hernia repairs were identified. There were 624 reoperations registered following primary umbilical repair and 137 following primary epigastric repairs. In multivariable Cox proportional hazard analysis, the hazard ratio (HR) for reoperation was 0.292 (95% confidence interval (CI) 0.109-0.782) after open onlay mesh repair, 0.484 (CI 0.366-0.641) after open interstitial mesh repair, 0.382 (CI 0.238-0.613) after open sublay mesh repair, 0.453 (CI 0.169-1.212) after open intraperitoneal onlay mesh repair, 1.004 (CI 0.688-1.464) after laparoscopic repair, and 0.940 (CI 0.502-1.759) after other techniques, when compared to open suture repair as reference method. Following umbilical hernia repair, the risk for reoperation was also significantly higher for patients aged < 50 years (HR 1.669, CI 1.389-2.005), for women (HR 1.401, CI 1.186-1.655), and for patients with liver cirrhosis (HR 2.544, CI 1.049-6.170). For patients undergoing epigastric hernia repair, the only significant risk factor for reoperation was age < 50 years (HR 2.046, CI 1.337-3.130).

Conclusions: All types of open mesh repair were associated with lower reoperation rates than open suture repair and laparoscopic repair. Female sex, young age and liver cirrhosis were risk factors for reoperation due to hernia recurrence, regardless of method.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 26, no 6, p. 1551-1559
Keywords [en]
Primary ventral hernia, Umbilical hernia, Epigastric hernia, Hernia repair, Recurrence, Reoperation
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-100287DOI: 10.1007/s10029-022-02645-3ISI: 000824981600001PubMedID: 35802262Scopus ID: 2-s2.0-85133638065OAI: oai:DiVA.org:oru-100287DiVA, id: diva2:1685405
Funder
Örebro UniversityAvailable from: 2022-08-02 Created: 2022-08-02 Last updated: 2023-12-08Bibliographically approved

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Katawazai, AWallin, G.

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