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Long-Term Follow-Up of Retromuscular Incisional Hernia Repairs : Recurrence and Quality of Life

Rogmark, Peder LU ; Smedberg, Sam and Montgomery, Agneta LU (2017) In World Journal of Surgery
Abstract

Purpose: Incisional hernia repair (IHR) with a mesh is necessary to achieve low recurrence rates and pain relief. In the short term, quality of life (QoL) is restored by IHR. Two centers pioneered the IHR in Sweden with the highly standardized Rives–Stoppa technique using a retromuscular mesh. We assessed long-term follow-up of recurrence rate and QoL. Methods: Medical records were searched for IHRs performed from 1998 to 2006 and included living patients with midline repairs. Questionnaires about physical status, complaints, and QoL (SF-36) were mailed, offering a clinical examination. Assessment of medical records of later surgery was performed in 2015. Results: Three hundred and one patients with midline incisional repairs were... (More)

Purpose: Incisional hernia repair (IHR) with a mesh is necessary to achieve low recurrence rates and pain relief. In the short term, quality of life (QoL) is restored by IHR. Two centers pioneered the IHR in Sweden with the highly standardized Rives–Stoppa technique using a retromuscular mesh. We assessed long-term follow-up of recurrence rate and QoL. Methods: Medical records were searched for IHRs performed from 1998 to 2006 and included living patients with midline repairs. Questionnaires about physical status, complaints, and QoL (SF-36) were mailed, offering a clinical examination. Assessment of medical records of later surgery was performed in 2015. Results: Three hundred and one patients with midline incisional repairs were identified, and 217 accepted participation. Of these, 103 attended a clinical examination. Follow-up was 7 years until examination and 11 years to reassessment of medical records. In 26%, recurrent hernias were repaired. Postoperative complications were 26% Clavien–Dindo grade I–II and 1% grade III–IV. Mesh infections occurred in 1.4% without mesh removals, and 4% were reoperated because of complications. Overall recurrence rate was 8.1% and two-third of which were diagnosed at clinical examination. Recurrence after primary and recurrent hernia repair was 7.1 and 10.9%, respectively. Of all patients, 80% were satisfied; dissatisfaction was primarily caused by recurrence and chronic pain. SF-36 scores were 0.2 SD lower than the norm in all subscales, similar to those with 1–2 chronic conditions. Conclusions: Midline retromuscular mesh IHR has a low long-term recurrence rate even after recurrent repair. Patient satisfaction was high although QoL was reduced.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
World Journal of Surgery
pages
7 pages
publisher
Springer
external identifiers
  • scopus:85030835114
ISSN
0364-2313
DOI
10.1007/s00268-017-4268-0
language
English
LU publication?
yes
id
dfb62c45-22db-4cb2-afaa-4a22a2b5b8d5
date added to LUP
2017-11-02 10:49:09
date last changed
2018-01-07 12:24:32
@article{dfb62c45-22db-4cb2-afaa-4a22a2b5b8d5,
  abstract     = {<p>Purpose: Incisional hernia repair (IHR) with a mesh is necessary to achieve low recurrence rates and pain relief. In the short term, quality of life (QoL) is restored by IHR. Two centers pioneered the IHR in Sweden with the highly standardized Rives–Stoppa technique using a retromuscular mesh. We assessed long-term follow-up of recurrence rate and QoL. Methods: Medical records were searched for IHRs performed from 1998 to 2006 and included living patients with midline repairs. Questionnaires about physical status, complaints, and QoL (SF-36) were mailed, offering a clinical examination. Assessment of medical records of later surgery was performed in 2015. Results: Three hundred and one patients with midline incisional repairs were identified, and 217 accepted participation. Of these, 103 attended a clinical examination. Follow-up was 7 years until examination and 11 years to reassessment of medical records. In 26%, recurrent hernias were repaired. Postoperative complications were 26% Clavien–Dindo grade I–II and 1% grade III–IV. Mesh infections occurred in 1.4% without mesh removals, and 4% were reoperated because of complications. Overall recurrence rate was 8.1% and two-third of which were diagnosed at clinical examination. Recurrence after primary and recurrent hernia repair was 7.1 and 10.9%, respectively. Of all patients, 80% were satisfied; dissatisfaction was primarily caused by recurrence and chronic pain. SF-36 scores were 0.2 SD lower than the norm in all subscales, similar to those with 1–2 chronic conditions. Conclusions: Midline retromuscular mesh IHR has a low long-term recurrence rate even after recurrent repair. Patient satisfaction was high although QoL was reduced.</p>},
  author       = {Rogmark, Peder and Smedberg, Sam and Montgomery, Agneta},
  issn         = {0364-2313},
  language     = {eng},
  month        = {10},
  pages        = {7},
  publisher    = {Springer},
  series       = {World Journal of Surgery},
  title        = {Long-Term Follow-Up of Retromuscular Incisional Hernia Repairs : Recurrence and Quality of Life},
  url          = {http://dx.doi.org/10.1007/s00268-017-4268-0},
  year         = {2017},
}