Long-Term Follow-Up of Technical Outcomes for Incisional Hernia Repair

摘要: Background Incisional hernia repair (IHR) is plagued by high recurrence rates and lack of long-term outcomes data to guide technique. Mesh reduces but lacks standardization We investigated elective IHR, focusing on technical predictors recurrence. Study Design This retrospective multicenter cohort study included IHR performed at 16 Veterans Affairs hospitals between 1997 2002. Hernia characteristics operative details were abstracted from notes, chart review was identify complications. Kaplan-Meier curves Cox regression models used evaluate the effects technique Results There 1,346 IHRs, which 22% recurrent hernias. Repair primary suture in 31%, open inlay or onlay mesh 30%, underlay laparoscopic 9%. At median follow-up 73.4 months, there 383 recurrences (28.5%), 23 removals (1.7%), 7 enterocutaneous fistulas (ECF) (0.5%). On modeling with adjustment for site characteristics, effectiveness varied position. Compared repair, (hazard ratio=0.49; 95% CI, 0.28−0.84) ratio=0.72; 0.53−0.98) substantially reduced risk, did not. position not affect removal ECF rates. Conclusions Underlay technique, either open, implantation during risk recurrence, without increasing serious infection ECF.