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Emergency repair and smoking predict recurrence in a large cohort of ventral hernia patients

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Abstract

Purpose

Ventral hernias are frequent and hernia repair is regularly performed by general surgeons. Emergency repair is less frequent and can be challenging. Long-term data comparing outcomes of emergency- vs. elective ventral hernia repair are scarce.

Methods

Consecutive patients undergoing emergency and elective ventral hernia repair at our institution were prospectively entered in our HerniaMed database between August 2013 and February 2020. Patients were contacted after 1 and 5 years to assess long-term complications. Risk factors for emergency repair and hernia recurrence were assessed by univariate and multivariate analysis.

Results

We included 1307 patients. Emergency and elective hernia repair were performed in 11% and 89% of patients with 1-year follow-up rates of 94% and 92%. Female gender, BMI > 40 kg/m2, ASA class 3 and 4, large size umbilical herniation (> 4 cm) and epigastric herniation were more frequent in emergency hernia repair. Binary logistic regression analysis identified emergency repair and smoking as predictors of recurrence (Odds ratio: 4.04 and 95% confidence interval: 1.67–14.21, p = 0.004; Odds ratio: 2.94 and 95% confidence interval: 1.33–9.15, p = 0.011). Furthermore, female gender and significant comorbidity (ASA class 3 and 4) were risk factors for emergency repair (Odds ratio: 1.98 and 95% confidence interval: 01.05–3.74, p = 0.034; Odds ratio: 3.54 and 95% confidence interval: 1.79–6.98, p < 0.001).

Conclusions

Emergency repair and smoking predicted hernia recurrence. Females and highly comorbid patients are at increased risk for emergency repair and should be prioritized for early elective hernia repair.

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Author notes

    Authors and Affiliations

    1. Department of Surgery, Cantonal Hospital of Baden, Im Ergel 1, 5404, Baden, Switzerland

      S. Soppe, S. Slieker, A. Keerl, A. Wirsching & A. Nocito

    2. Department of Surgery, Cantonal Hospital of Frauenfeld, Frauenfeld, Switzerland

      M.K. Muller

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    1. S. Soppe
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    2. S. Slieker
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    3. A. Keerl
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    Correspondence to A. Nocito.

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    Conflict of interest

    S. Soppe, S. Slieker, A. Keerl, M. Müller, A. Wirsching and A. Nocito declare that they have no conflict of interest.

    Compliance with ethics requirements

    This study was approved by the local ethic committee (project ID: 2021-02205).

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    HerniaMed informed consent was signed by all patients.

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    Soppe, S., Slieker, S., Keerl, A. et al. Emergency repair and smoking predict recurrence in a large cohort of ventral hernia patients. Hernia 26, 1337–1345 (2022). https://doi.org/10.1007/s10029-022-02672-0

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    • DOI: https://doi.org/10.1007/s10029-022-02672-0

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