Predictors of recurrence of umbilical hernias following primary tissue repair in obese veterans

• Published in: The American journal of surgery 2016-01, Vol.211 (1), p.18-23
• Main Authors: Yao, Jie J., B.A, Pham, Thai, M.D., F.A.C.S, Mokdad, Ali El, M.D, Huerta, Sergio, M.D., F.A.C.S
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Body Mass Index; Chronic obstructive pulmonary disease; Confidence intervals; Defects; Diabetes; Female; Follow-Up Studies; Hernia, Umbilical - complications; Hernia, Umbilical - surgery; Hernias; Herniorrhaphy; Humans; Hypertension; Imprisonment; Incisional hernia; Kidney diseases; Laparoscopic hernia repair; Logistic Models; Male; Medical personnel; Middle Aged; Multivariate analysis; Obesity; Obesity - complications; Postoperative Complications - etiology; Recurrence; Recurrent hernia; Retrospective Studies; Risk Factors; Skin; Surgery; Texas; Treatment Outcome; Variance analysis; Ventral hernia; Veterans Health
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2015.03.014

Abstract Background Factors that determine recurrence and complications following primary tissue repair of umbilical hernias (UHs) and the approach to repair UHs in obese patients need further analysis. Methods A retrospective review of UH repair (UHR) conducted at our institution was undertaken. Patients were grouped by body mass index (BMI) and compared for recurrence and complications. Univariate and multivariate analyses were performed. Results In total, 199 patients (BMI 32.3 kg/m2 , 97% male, 77% Caucasian, American Society of Anesthesiologists class III/IV 59.2%) underwent primary tissue UHR. There were 8 recurrences (4.0%); average follow-up 3.9 ± 2.4 years (range 30 days to 9.2 years). There were no recurrences among normal BMI patients (0/11); 3 in overweight (3/54), 2 in class I obese (2/73), 2 in class II obese (2/47), and 1 in morbidly obese (1/14) patients ( P = .84). Albumin and American Society of Anesthesiologists were similar in all groups. Recurrence rates among obese and nonobese patients were not significantly different (3.7% vs 4.6%, P = .72). There were 18 (9.0%) complications. BMI was not associated with complications. Conclusion Primary tissue repair is a feasible approach for UHR in obese patients.