Long-term follow-up (at 5 years) of midline incisional hernia repairs using a primary closure and prosthetic onlay technique: recurrence and quality of life

• Published in: Hernia : the journal of hernias and abdominal wall surgery 2018-04, Vol.22 (2), p.319-324
• Main Authors: Juvany, M., Hoyuela, C., Carvajal, F., Trias, M., Martrat, A., Ardid, J.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Hernia; Medicine; Medicine & Public Health; Obesity; Original Article; Prostheses; Quality of life; Surgery
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-018-1730-3

Introduction and objectives The recurrence rate of incisional hernia (IH) repair is usually underestimated due to a lack of long-term follow-up. The objective of this study was to evaluate recurrence rate for patients operated on midline IH surgery, using a primary closure and prosthetic onlay technique, 5 years after the procedure. Materials and methods From January 2009 to January 2011, all 92 patients operated on elective midline IH repair by primary closure and prosthetic onlay technique in a General Surgery Department were retrospectively included in the study. Exclusion criteria were absence of follow-up or death. Recurrence rate and quality of life were assessed. Demographic, surgical data and quality of life in patients with and without 5-year recurrence were compared. Results Mean follow-up was 64 months. Ultimately, 76 patients were included in the study, representing 82% of the selected patients during the study period (76/92), of whom 24 presented a recurrence (32%). Half (12) were diagnosed for recurrence more than 3 years after the surgery. Patients who developed a recurrence had more percentage of obesity (64 vs. 29%, p  = 0.016), which denoted an odds ratio (OR) for recurrence of 4.4 (1.2–15.7; p  = 0.01) and they punctuated lower in quality of life (6.0 ± 2.9 vs. 7.6 ± 2.6, p  = 0.006). Conclusions Recurrence rate on midline IH repair is still a concern (32% at 5 years). It is advisable to look for other strategies and more efficient surgical techniques for IH surgery, especially in obese patients.