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Recurrent incisional hernia repair: surgical outcomes in correlation with body-mass index

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Abstract

Background

Hernia recurrence rates after incisional hernia repair vary between 8.7 and 32%, depending on multiple factors such as patient characteristics, the use of meshes, surgical technique and the degree of experience of the treating surgeon. Recurrent hernias are considered complex wall hernias, and 20% of all incisional hernia repairs involve a recurrent hernia. The aim of this study was to investigate the outcomes after recurrent incisional hernia repair, in association with surgical technique and body-mass index (BMI).

Methods

All patients who had incisional hernia repair between 2013 and 2018 were included. Primary outcome was rate of recurrent incisional hernia after initial hernia repair. Secondary outcomes were complication rate and recurrence rate in association with BMI.

Results

A number of 269 patients were included, of which 75 patients (27.9%) with a recurrent incisional hernia. Recurrent hernia repair was performed in 49 patients, 83.7% underwent open repair. Complication rate for recurrent hernia repair was higher than for the initial incisional hernia repair. Of the 49 patients with recurrent hernia repair, patients with a BMI above 30 had higher complication and recurrence rates compared to patients with BMI below 30. Especially infectious complications were more common in patients with a higher BMI: 23.1% vs. 0% wound infections.

Conclusion

The results from this study show that complication and recurrence rates are increased after recurrent incisional hernia repair, which are further increased by obesity. Only a limited amount of literature is available on this topic, further larger multicenter studies are necessary, until then a patient-specific surgical approach based on the surgeon’s expertise is recommended.

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Acknowledgements

We thank the Ventral Hernia Group Tilburg for contributing to this study.

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Authors and Affiliations

  1. Department of Surgery, ETZ, Tilburg, The Netherlands

    L. van Silfhout, L. A. M. Leenders, J. Heisterkamp & M. S. Ibelings

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  1. L. van Silfhout
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  2. L. A. M. Leenders
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  3. J. Heisterkamp
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  4. M. S. Ibelings
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the Ventral Hernia Group Tilburg

Corresponding author

Correspondence to L. van Silfhout.

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Conflict of interest

L van Silfhout, LAM Leenders, J Heisterkamp and MS Ibelings declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent from the included patients was not required because the patients’ data were already collected for and used in a different research project. For the same reason, the study was not assessed by the IRB or local ethical committee.

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van Silfhout, L., Leenders, L.A.M., Heisterkamp, J. et al. Recurrent incisional hernia repair: surgical outcomes in correlation with body-mass index. Hernia 25, 77–83 (2021). https://doi.org/10.1007/s10029-020-02320-5

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  • DOI: https://doi.org/10.1007/s10029-020-02320-5

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