Suture or Mesh Repair of the Smallest Umbilical Hernias: A Nationwide Database Study
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Suture or Mesh Repair of the Smallest Umbilical Hernias : A Nationwide Database Study. / Henriksen, Nadia A.; Jensen, Kristian Kiim; Bisgaard, Thue; Helgstrand, Frederik; the Danish Hernia Database.
I: World Journal of Surgery, Bind 46, Nr. 8, 2022, s. 1898-1905.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Suture or Mesh Repair of the Smallest Umbilical Hernias
T2 - A Nationwide Database Study
AU - Henriksen, Nadia A.
AU - Jensen, Kristian Kiim
AU - Bisgaard, Thue
AU - Helgstrand, Frederik
AU - the Danish Hernia Database
N1 - Publisher Copyright: © 2022, The Author(s) under exclusive licence to Société Internationale de Chirurgie.
PY - 2022
Y1 - 2022
N2 - Background: Mesh is recommended for umbilical hernias with defects > 1 cm to reduce recurrence. For umbilical hernias with defect width ≤ 1 cm, the literature is sparse. The aim of this nationwide cohort study was to assess outcomes after suture and mesh repair of umbilical hernias with defect width ≤ 1 cm and to evaluate outcomes after onlay mesh repair specifically. Methods: By merging data from the Danish Hernia Database and the National Patients Registry from 2007 to 2018, patients undergoing elective open repair of an umbilical hernia with defect width ≤ 1 cm were identified. Available data included details about comorbidity, surgical technique, 90-day readmission, 90-day reoperation and operation for recurrence. Results: A total of 7849 patients were included, of whom 25.7% (2013/7849) underwent mesh repair. Reoperation for recurrence was significantly decreased after mesh repair 3.1% (95% C.I. 2.1–4.1) compared with suture repair 6.7% (95% C.I. 6.0–7.4), P < 0.001. Readmission and reoperation rates were significantly higher for mesh repair 7.9% (159/2013) and 2.6% (52/2013) than for suture repair 6.5% (381/5836) and 1.5% (89/5836), P = 0.036 and P = 0.002, respectively. Onlay mesh repairs had the lowest risk of recurrence 2.0% (95% C.I. 0.6–3.5), and readmission [7.9% (65/826)] and reoperation [3.9% (32/826)] rates within 90 days were comparable to suture repairs [6.5% (381/5836)] and [3.3% (192/5836)], P = 0.149 and P = 0.382, respectively. Conclusions: Even for the smallest umbilical hernias, mesh repair significantly decreased the recurrence rate. Onlay mesh repair was associated with lowest risk of recurrence without increasing early complications.
AB - Background: Mesh is recommended for umbilical hernias with defects > 1 cm to reduce recurrence. For umbilical hernias with defect width ≤ 1 cm, the literature is sparse. The aim of this nationwide cohort study was to assess outcomes after suture and mesh repair of umbilical hernias with defect width ≤ 1 cm and to evaluate outcomes after onlay mesh repair specifically. Methods: By merging data from the Danish Hernia Database and the National Patients Registry from 2007 to 2018, patients undergoing elective open repair of an umbilical hernia with defect width ≤ 1 cm were identified. Available data included details about comorbidity, surgical technique, 90-day readmission, 90-day reoperation and operation for recurrence. Results: A total of 7849 patients were included, of whom 25.7% (2013/7849) underwent mesh repair. Reoperation for recurrence was significantly decreased after mesh repair 3.1% (95% C.I. 2.1–4.1) compared with suture repair 6.7% (95% C.I. 6.0–7.4), P < 0.001. Readmission and reoperation rates were significantly higher for mesh repair 7.9% (159/2013) and 2.6% (52/2013) than for suture repair 6.5% (381/5836) and 1.5% (89/5836), P = 0.036 and P = 0.002, respectively. Onlay mesh repairs had the lowest risk of recurrence 2.0% (95% C.I. 0.6–3.5), and readmission [7.9% (65/826)] and reoperation [3.9% (32/826)] rates within 90 days were comparable to suture repairs [6.5% (381/5836)] and [3.3% (192/5836)], P = 0.149 and P = 0.382, respectively. Conclusions: Even for the smallest umbilical hernias, mesh repair significantly decreased the recurrence rate. Onlay mesh repair was associated with lowest risk of recurrence without increasing early complications.
U2 - 10.1007/s00268-022-06520-1
DO - 10.1007/s00268-022-06520-1
M3 - Journal article
C2 - 35306587
AN - SCOPUS:85127111931
VL - 46
SP - 1898
EP - 1905
JO - World Journal of Surgery
JF - World Journal of Surgery
SN - 0364-2313
IS - 8
ER -
ID: 315475872