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- Title
A consecutive series of 235 epigastric hernias.
- Authors
Ponten, J.; Leenders, B.; Charbon, J.; Nienhuijs, S.; Ponten, J E H; Leenders, B J M; Charbon, J A; Nienhuijs, S W
- Abstract
<bold>Background: </bold>Epigastric herniation is a common, though not always symptomatic condition. It is likely, that in accordance to the tension-free principles for other hernias, epigastric hernia repair should be mesh based.<bold>Methods: </bold>Patients from two large hospitals were investigated retrospectively if they were operated on an epigastric hernia for the past 6 years. Follow-up was completed with a postal questionnaire.<bold>Results: </bold>A total of 235 patients (50 % male) were operated. Sixty-eight patients were operated with mesh and 167 patients with suture repair. Forty-six patients were loss-to follow-up (19.6 %). In the mesh operated patients the recurrence rate was 10.9 % (n = 6) compared to 14.9 % (n = 20) in the suture repair group. Cox-regression analysis showed an increased risk for recurrence in the suture repair group (odds ratio 1.43; 95 % CI 0.56-3.57; p = 0.44). Operation time for mesh repair (47 min) was significantly longer compared to suture repair (29 min) (p < 0.0001). Thirty-seven patients had previous or other anterior wall hernias. A total of 51 patients smoked and 14 patients had diabetes mellitus. Fourteen patients used steroids and 22 patients suffered from a chronic lung disease. Subgroup analysis showed a significant difference for pain in patients in which re-operation for a recurrence occurred (p = 0.004).<bold>Conclusions: </bold>This is one of the largest reported series on solely epigastric hernias. A recurrence occurred more often after sutured repair compared to mesh repair. No differences in chronic pain was seen between mesh and suture repaired patients. Male:female ratio of 1:1, which is different from the 3:1 ratio found in previous older smaller studies, could be more reliable.
- Subjects
HERNIA surgery; REOPERATION; SUTURES; DISEASE relapse; RETROSPECTIVE studies; SURGICAL meshes
- Publication
Hernia, 2015, Vol 19, Issue 5, p821
- ISSN
1265-4906
- Publication type
journal article
- DOI
10.1007/s10029-014-1227-7