Factors affecting recurrence in tension-free hernioplasties

Summary

We investigated the factors affecting recurrence rate in tension-free hernioplasties in the hope of obtaining better results. Tension-free hernioplasty is an easy procedure with very low reported recurrence rates of 0–1.7%. But the causes of failures in open mesh repairs have not been well estabushed. During this prospective study from January 1993 to December 1997 a total of 383 tension free hernioplasties were performed. The influence of some factors including age, sex, type of repaired hernia according to the Nyhus classification, simultaneous bilateral repair, previous hernia operation on the opposite side, chronic constipation, chronic obstructive lung disease, benign prostatic hypertrophy, smoking, previous appendectomy, early postoperative complications and surgical site infection on the recurrence rate were investigated using univariate and multivariate analyses. After a follow-up period of 16 to 62 months (mean 38.2 months) 5 out of 383 repairs failed with a recurrence rate of 1.3%. As a result of logistic regression analysis direct hernia, chronic constipation and surgical site infection were found to be independent risk factors for recurrence. The recurrence rates of tension-free hernioplasties can be reduced by the use of proper surgical techniques, early management of surgical site infection and treatment of chronic constipation.