O47 MESH-RELATED COMPLICATIONS, CHRONIC PAIN, AND ECONOMIC CLAIM COMPENSATION AFTER UMBILICAL HERNIA REPAIR

Abstract Aim The risk of mesh-related surgical complications after umbilical hernia repair is not known and chronic pain has only sparsely been analysed. Economic claims may represent a surrogate for poor postoperative surgical outcomes. Thus, the present study used mesh-related complications and chronic pain as primary and secondary outcomes, respectively. Material and Methods Blinded assessment of Swedish and Danish nationwide consecutive economic claim data from 2007 –2019. The study variables and outcomes were pre-study defined. Major complications were defined as acutely life-threatening complications requiring emergency surgery, clinically important complications were defined as all complications requiring surgical intervention but not emergency surgery. Results During the 13-years study period 181 patients were eligible for analysis. There were 96 patients with a surgical complication. In 52 (54%) and 44 (46%) patients the complication was mesh- or non-mesh-related, respectively. In the group of mesh- and non-mesh-related complications, major complications were found in 14 (14,6%) vs 21 (21,9%) patients and clinically important complications were found in 38 (39,5%) vs 23 (23,9%) patients respectively (P < 0.05). Chronic pain was reported in 18%, followed by wound complications (14%) and cosmetic claim reasons (11%). After open repair, claim because of chronic pain was significantly more common after mesh repair (48%) compared with non-mesh repairs (32%), P = 0.05. The economic compensation after a mesh- and non-mesh complication was 3,488€ (291 – 188,186€) and 2,342€ (507€ - 58,437€) (P = 0.55), respectively. Conclusions Mesh-repair was related to postoperative complications and chronic pain after umbilical hernia repair

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Long-term follow-up after umbilical hernia repair: are there risk factors for recurrence after simple and mesh repair

Hernia ◽

10.1007/s10029-005-0010-1 ◽

2005 ◽

Vol 9 (4) ◽

pp. 334-337 ◽

Cited By ~ 62

Author(s):

J. A. Halm ◽

J. Heisterkamp ◽

H. F. Veen ◽

W. F. Weidema

Keyword(s):

Risk Factors ◽

Hernia Repair ◽

Mesh Repair ◽

Umbilical Hernia ◽

Umbilical Hernia Repair ◽

Long Term Follow Up ◽

Risk Factors For Recurrence

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Umbilical hernia repair and recurrence: need for a clinical trial?

BMC Surgery ◽

10.1186/s12893-021-01358-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jennifer Mannion ◽

Mohamed Khalid Hamed ◽

Ritu Negi ◽

Alison Johnston ◽

Magda Bucholc ◽

...

Keyword(s):

Systematic Review ◽

Hernia Repair ◽

Mesh Repair ◽

Umbilical Hernia ◽

Hernia Recurrence ◽

Cochrane Library ◽

Large Defect ◽

Linea Alba ◽

Multiple Defects ◽

Umbilical Hernia Repair

Abstract Introduction Umbilical hernia repair, despite its perceived simplicity, is associated with recurrence between 2.7 and 27%, in mesh repair and non mesh repair respectively. Many factors are recognized contributors to recurrence however multiple defects in the linea alba, known to occur in up to 30% of patients, appear to have been overlooked by surgeons. Aims This systematic review assessed reporting of second or multiple linea alba defects in patients undergoing umbilical hernia repair to establish if these anatomical variations could contribute to recurrence along with other potential factors. Methods A systematic review of all published English language articles was undertaken using databases PubMed, Embase, Web of Science and Cochrane Library from January 2014 to 2019. The search terms ‘Umbilical hernia’ AND ‘repair’ AND ‘recurrence’ were used across all databases. Analysis was specified in advance to avoid selection bias, was registered with PROSPERO (154173) and adhered to PRISMA statement. Results Six hundred and forty-six initial papers were refined to 10 following article review and grading. The presence of multiple linea alba defects as a contributor to recurrence was not reported in the literature. One paper mentioned the exclusion of six participants from their study due multiple defects. In all 11 factors were significantly associated with umbilical hernia recurrence. These included: large defect, primary closure without mesh, high BMI in 5/10 publications; smoking, diabetes mellitus, surgical site Infection (SSI) and concurrent hernia in 3/10. In addition, the type of mesh, advanced age, liver disease and non-closure of the defect were identified in individual papers. Conclusion This study identified many factors already known to contribute to umbilical hernia recurrence in adults, but the existence of multiple defects in the linea, despite it prevalence, has evaded investigators. Surgeons need to be consider documentation of this potential confounder which may contribute to recurrence.

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Trocar umbilical hernia repair by open suture repair and open suture–mesh repair in an ambulatory setting in comparison to recurrent and primary umbilical hernia repair

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa270 ◽

2020 ◽

Vol 2020 (9) ◽

Author(s):

René G Holzheimer ◽

Nikolai Gaschütz

Keyword(s):

Hernia Repair ◽

Mesh Repair ◽

Umbilical Hernia ◽

Late Onset ◽

Recurrent Hernia ◽

Ambulatory Setting ◽

Suture Repair ◽

Umbilical Hernia Repair ◽

Trocar Hernia

Abstract Reports on the ambulatory open repair of umbilical trocal hernias are missing. Patients with trocar, primary and recurrent umbilical hernia open suture and open suture–mesh repair with prospective follow-up were retrospectively evaluated. Patients received perioperative antibiotic prophylaxis, preemptive analgesia and modified anesthesia. In total, 171 patients with umbilical hernia (51 years, female 14%; male 86%) were treated with open suture (n = 29; 17%) and suture–mesh (n = 142; 83%) repair. In total, 10% of patients were treated for trocar hernia (late onset), 5% for recurrent hernia and 85% for a primary umbilical hernia. In total, 29% of trocar hernia repairs had minor complications associated with obesity (40%) and comorbidity (80%). Age, suture and suture–mesh repair were not associated with complications. According to guidelines for umbilical hernia repair open flat mesh may be useful in the treatment of trocar hernia.

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