Incisional hernia recurrence after open elective repair : expertise in abdominal wall surgery matters
Pereira-Rodríguez, J. A. (Universitat Pompeu Fabra. Departament de Ciències Experimentals i de la Salut)
Bravo-Salva, Alejandro (Parc de Salut MAR de Barcelona)
Montcusí, B. (Parc de Salut MAR de Barcelona)
Pérez-Farre, S. (Parc de Salut MAR de Barcelona)
Fresno De Prado, L. (Universitat Pompeu Fabra. Departament de Ciències Experimentals i de la Salut)
López-Cano, Manuel (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	Background: Recurrence after incisional hernia repair is one of the major problems related with this operation. Our objective is to analyze the influence of abdominal wall surgery expertise in the results of the open elective repair of incisional hernia. Methods: We have compiled the data of a cohort of patients who received surgery for an incisional hernia from July 2012 to December 2015 in a University Hospital. Data were collected prospectively and registered in the Spanish Register of Incisional Hernia (EVEREG). The short- and long-term complications between the groups of patients operated on by the Abdominal Wall Surgery (AWS) unit and groups operated on by surgeons outside of the specialized abdominal wall group (GS) were compared. Results: During the study period, a total of 237 patients were operated on by the open approach (114 AWS; 123 GS). One hundred seventy-five patients completed a median follow-up of 36. 6 months [standard deviation (SD) = 6]. Groups were comparable in terms of age, sex, body mass index (BMI), comorbidities, and complexity of hernia. Complications were similar in both groups. Patients in the AWS group presented fewer recurrences (12. 0% vs. 28. 9%; P = 0. 005). The cumulative incidence of recurrence was higher in the GS group [log rank 13. 370; P < 0. 001; odds ratio (OR) = 37. 8; 95% confidence interval (CI) = 30. 3-45. 4]. In the multivariate analysis, surgery performed by the AWS unit was related to fewer recurrences (OR = 0. 19; 95%CI = 0. 07-0. 58; P < 0. 001). Conclusion: Incisional hernia surgery is associated with better results in terms of recurrence when it is performed in a specialized abdominal wall unit.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Incisional hernia ; Open repair ; Expertise ; Recurrence ; Abdominal wall unit
Publicado en:	BMC Surgery, Vol. 19 Núm. 1 (july 2019) , p. 103, ISSN 1471-2482

DOI: 10.1186/s12893-019-0569-6
PMID: 31391112

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