Chronic complaints after simple sutured repair for umbilical or epigastric hernias may be related to recurrence

TY - JOUR

T1 - Chronic complaints after simple sutured repair for umbilical or epigastric hernias may be related to recurrence

AU - Westen, Mikkel

AU - Christoffersen, Mette W

AU - Jorgensen, Lars N

AU - Stigaard, Trine

AU - Bisgaard, Thue

PY - 2014/1

Y1 - 2014/1

N2 - Purpose: Umbilical and epigastric hernia repairs are minor, but are commonly conducted surgical procedures. Long-term results have only been sparsely investigated. Our objective was to investigate the risk of chronic complaints after a simple sutured repair for small umbilical and epigastric hernias. Methods: A retrospective cohort study with a 5-year questionnaire and clinical follow-up was conducted. Patients undergoing primary elective, open non-mesh umbilical or epigastric sutured hernia repair were included. Patients completed a structured questionnaire regarding chronic complaints during work and leisure activities using a verbal rating scale. The primary outcome was chronic complaints. Results: A total of 295 patients were included for analysis after a median of 5.0-year (range 2.8-8.0) follow-up period. Follow-up results were achieved from 262 of the included patients (90 % response rate). Up till 5.8 % of the patients reported moderate or severe pain and discomfort. Work and leisure activities were restricted in 8.5 and 10.0 % of patients, respectively. Patients with chronic complaints had a higher incidence of recurrence (clinical and reoperation), than patients with none or mild complaints (78.6 vs. 22.2 % (P < 0.001)). The recurrence rate was significantly higher after a repair with absorbable suture (20.1 %) compared with non-absorbable suture repair (4.2 %) (P < 0.001). Conclusion: We found that chronic complaints after a simple sutured umbilical or epigastric repair was in the level of 5.5 % and could in part be explained by recurrence. Furthermore, absorbable suture should be omitted to reduce risk of recurrence.

AB - Purpose: Umbilical and epigastric hernia repairs are minor, but are commonly conducted surgical procedures. Long-term results have only been sparsely investigated. Our objective was to investigate the risk of chronic complaints after a simple sutured repair for small umbilical and epigastric hernias. Methods: A retrospective cohort study with a 5-year questionnaire and clinical follow-up was conducted. Patients undergoing primary elective, open non-mesh umbilical or epigastric sutured hernia repair were included. Patients completed a structured questionnaire regarding chronic complaints during work and leisure activities using a verbal rating scale. The primary outcome was chronic complaints. Results: A total of 295 patients were included for analysis after a median of 5.0-year (range 2.8-8.0) follow-up period. Follow-up results were achieved from 262 of the included patients (90 % response rate). Up till 5.8 % of the patients reported moderate or severe pain and discomfort. Work and leisure activities were restricted in 8.5 and 10.0 % of patients, respectively. Patients with chronic complaints had a higher incidence of recurrence (clinical and reoperation), than patients with none or mild complaints (78.6 vs. 22.2 % (P < 0.001)). The recurrence rate was significantly higher after a repair with absorbable suture (20.1 %) compared with non-absorbable suture repair (4.2 %) (P < 0.001). Conclusion: We found that chronic complaints after a simple sutured umbilical or epigastric repair was in the level of 5.5 % and could in part be explained by recurrence. Furthermore, absorbable suture should be omitted to reduce risk of recurrence.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Follow-Up Studies

KW - Hernia, Abdominal

KW - Hernia, Umbilical

KW - Herniorrhaphy

KW - Humans

KW - Male

KW - Middle Aged

KW - Postoperative Complications

KW - Questionnaires

KW - Recurrence

KW - Reoperation

KW - Retrospective Studies

KW - Risk Factors

KW - Suture Techniques

KW - Young Adult

U2 - 10.1007/s00423-013-1119-9

DO - 10.1007/s00423-013-1119-9

M3 - Journal article

C2 - 24037253

SN - 1435-2443

VL - 399

SP - 65

EP - 69

JO - Langenbecks Archives of Surgery

JF - Langenbecks Archives of Surgery

IS - 1

ER -