Hernia recurrence after primary repair of small umbilical hernia defects

Am J Surg. 2022 Dec;224(6):1357-1361. doi: 10.1016/j.amjsurg.2022.09.019. Epub 2022 Sep 24.

Abstract

Background: An evidence-based approach to the repair of umbilical hernias (UH)<1 cm has yet to be defined.

Methods: A prospectively maintained, institutional hernia database was queried for patients undergoing primary suture repair of UH ≤ 1 cm. The primary outcome was recurrence and secondary outcomes were wound complications.

Results: Of 332 patients included (226-primary, 106-incisional), recurrence was identified in 4 (1.8%) primary versus 8 (7.5%) incisional-UH (p = 0.022), with follow-up of 4.7 ± 4.4 years. There were 10 (3.0%) wound complications: 4 (1.2%) superficial wound infections, 1 (0.3%) superficial wound dehiscence, and 5 (1.5%) seromas. On multivariable analysis of recurrence, incisional-UH had an odds ratio of 4.2 compared to primary. Suture choice, diabetes, BMI, tobacco-use history, and wound complications were not significant.

Conclusions: With long term follow-up, recurrence after primary suture repair of UH ≤ 1 cm occurred in 1.8% of primary and 7.5% of incisional UH. On multivariable analysis, incisional-UH increased recurrence odds by 4.2 times compared to primary.

MeSH terms

  • Hernia, Umbilical* / surgery
  • Hernia, Ventral* / surgery
  • Herniorrhaphy / adverse effects
  • Humans
  • Incisional Hernia* / surgery
  • Neoplasm Recurrence, Local / surgery
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh / adverse effects