scholarly journals Incisional hernia repair in women of childbearing age: A nationwide propensity-score matched study

2019 ◽  
Vol 109 (4) ◽  
pp. 295-300
Author(s):  
E. Oma ◽  
K. K. Jensen ◽  
L. N. Jorgensen ◽  
T. Bisgaard
Keyword(s):  
Chronic Pain ◽  
Propensity Score ◽  
Confidence Interval ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Subsequent Pregnancy ◽  
Secondary Outcome ◽  
Women Of Childbearing Age ◽  
Childbearing Age

Background & Aims: Although incisional hernia repair in women of childbearing age is not rare, hernia disease in this group of patients is sparsely documented. The aim of this study was to examine long-term clinical results after incisional hernia repair in women of childbearing age. Material and methods: This nationwide cohort study examined incisional hernia repair from 2007 to 2013 in women of childbearing age, registered prospectively in the Danish Ventral Hernia Database. All women with a subsequent pregnancy were included, and a 1:3 propensity-score matched group of women with an incisional hernia repair without a subsequent pregnancy. A prospective follow-up was conducted, including a validated questionnaire. The primary outcome was recurrence, and the secondary outcome was chronic pain from the operated site. Results: In total, 124 (70.5%) women responded, 47 and 77 women with and without a subsequent pregnancy, respectively. The 5-year cumulative incidence of recurrence was 41.0% (95% confidence interval 32.0%–49.9%). After adjustment for potential confounders, subsequent pregnancy was independently associated with recurrence (hazard ratio 1.83, 95% confidence interval 1.02–3.29, p = 0.044). Twenty-six (21.0%) women reported chronic pain (moderate, n = 21; severe, n = 5) with no difference between women with and without a subsequent pregnancy. Hernia recurrence, higher body mass index, and smoking were associated with chronic pain. Conclusion: Pregnancy following incisional hernia repair was associated with an increased risk of recurrence, but not with chronic pain.

scholarly journals Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Hernia ◽  
2019 ◽  
Vol 24 (3) ◽  
pp. 567-576 ◽  
Author(s):  
F. Köckerling ◽  
H. Hoffmann ◽  
D. Adolf ◽  
D.Weyhe ◽  
W. Reinpold ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Risk Factor ◽  
Propensity Score ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Surgical Procedures ◽  
Independent Risk Factor ◽  
Incisional Hernia Repair ◽  
Female Sex ◽  
Onlay Technique

Abstract Introduction To date, little attention has been paid by surgical scientific studies to sex as a potential influence factor on the outcome. Therefore, there is a sex bias in the surgical literature. With an incidence of more than 20% after 3 years, incisional hernias are a common complication following abdominal surgical procedures. The proportion of women affected is around 50%. There are very few references in the literature to the influence of sex on the outcome of elective incisional hernia repair. Materials and methods In all, 22,895 patients with elective incisional hernia repair from the Herniamed Registry were included in the study. The patients had undergone elective incisional hernia repair in a laparoscopic IPOM, open sublay, open IPOM, open onlay or suture technique. 1-year follow-up was available for all patients. Propensity score matching was performed for the 11,480 female (50.1%) and 11,415 male (49.9%) patients, creating 8138 pairs (82.0%) within fixed surgical procedures. Results For pain on exertion (11.7% vs 18.3%; p < 0.001), pain at rest (7.53% vs 11.1%; p < 0.001), and pain requiring treatment (5.4% vs 9.1%; p < 0.001) highly significant disadvantages were identified for the female sex when comparing the different results within the matched pairs. That was also confirmed on comparing sex within the individual surgical procedures. No sex-specific differences were identified for the postoperative complications, complication-related reoperations or recurrences. Less favorable intraoperative complication results in the female sex were observed only for the onlay technique. Conclusions Female sex is an independent risk factor for chronic pain after elective incisional hernia repair.

Increased risk of postoperative complications with retromuscular mesh placement in emergency incisional hernia repair: A nationwide register-based cohort study

2020 ◽  
pp. 145749692096623
Author(s):  
N. Juul ◽  
N. A. Henriksen ◽  
K. K. Jensen
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Secondary Outcome ◽  
Emergency Setting ◽  
Mesh Placement ◽  
Increased Risk ◽  
Elective Repair ◽  
Onlay Mesh

Introduction: Incisional hernia is common after abdominal surgery. Watchful waiting carries the risk of incarceration and a need for emergency intervention. The aim of this study was to examine the risk of postoperative complications after emergency versus elective incisional hernia repair. Methods: Patients above 18 years of age undergoing open incisional hernia repair in Denmark in 2017–2018 were identified in the Danish Ventral Hernia Database. Patients were grouped according to elective or emergency hernia repair. The primary outcome was postoperative complications requiring operative intervention within 90 days, and the secondary outcome was postoperative length of stay. Results: We included 1050 patients, of whom 882 were admitted for elective and 168 for emergency operation. Patients undergoing emergency repair were older (64.7 years vs 59.2 years, p < 0.001), more often smokers (25.8% vs 13.6%, p = 0.003), and more often had a Charlson comorbidity score ⩾2 (26.8% vs 19.2%, p = 0.005) compared to patients undergoing elective repair. In a multivariate regression analysis, emergency compared to elective operation (OR = 2.71, 95% CI = 1.4–5.25, p = 0.003) and retromuscular compared to onlay mesh placement (OR = 2.14, 95% CI = 1.08–4.24, p = 0.013) were factors significantly associated with increased risk of postoperative complications. In a subgroup analysis including only emergency repairs, risk of complications after retromuscular mesh placement was even higher (OR = 10.12, 95% CI = 1.81–56.68, p = 0.008). Conclusion: Emergency incisional hernia repair was associated with increased risk of postoperative complications and this risk was accentuated with retromuscular mesh placement. The use of retromuscular mesh in the emergency setting should be avoided, and the abdominal wall could either be closed by sutures or additional onlay mesh.

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