Multivariate Analysis of Recurrence of Incisinonal Hernia Following Incisional Hernia Tension-Free Repair_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHOULi ^1,2 , WANGXiao-hui ^1,2 ,  LIXiao-jun ² , LIURui-ting ²

1. Department of General Surgery, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi Province, China;
2. Yan'an University School of Medicine, Yan'an 716000, Shaanxi Province, China;

Corresponding author：

LIXiao-jun, Email: lixiaojun20040912@163.com

Keywords：

Incisional hernia; Surgical procedure; Recurrence; Risk factor

DOI：

10.7507/1007-9424.20150253

Video：

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Objective To explore the risk factors of recurrence of incisional hernia following incisional hernia tension-free repair. Methods The clinical data of 162 patients with incisional hernia underwent tension-free repair were retrospectively analyzed in this hospital from January 2005 to January 2011. The relationships of incisional hernia recur-rence to gender, age, body mass index, hernia size, abdominal wall defect site, preoperative chronic comorbidities, type of tension-free repair, operation time, and wound healing disorders were analyzed by univariate and multivariate analysis. Results One hundred and sixty-two patients were followed up 7-70 months with mean 34.5 months. The rate of recur-rence following incisional hernia tension-free repair was 9.26% (15/162). The results of univariate analysis showed that recurrence following incisional hernia tension-free repair was associated with the age (P < 0.05), body mass index (P < 0.05), type of tension-free repair (P < 0.05), hernia size (P < 0.05), and wound healing disorders (P < 0.05). The results of multivariate logistic regression revealed that the body mass index, type of tension-free repair, hernia size, and wound healing disorders were the independent risk factors associated with recurrence following incisional hernia tension-free repair. Fifteen recurrent patients were reperformed successfully. There was no recurrence following up with an average 23 months. Conclusions It is necessary to become familiar with the risk factors for recurrence of incisional hernia in order to eliminate or decrease their effects on the positive outcome of incisional herniorrhaphy. The patients with fat, hernia ring bigger, incorrect opera-tion or wound healing disorders might be easy to relapse. Surgical approach should be individualized for recurrence.

Citation： ZHOULi, WANGXiao-hui, LIXiao-jun, LIURui-ting. Multivariate Analysis of Recurrence of Incisinonal Hernia Following Incisional Hernia Tension-Free Repair. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 972-976. doi: 10.7507/1007-9424.20150253 Copy

1.	Fink C, Baumann P, Wente MN, et al. Incisional hernia rate 3 years after midline laparotomy. Br J Surg, 2014, 101(2):51-54.
2.	Vidović D, Jurisić D, Franjić BD, et al. Factors affecting recurrence after incisional hernia repair. Hernia, 2006, 10(4):322-325.
3.	Rios A, Rodriguez JM, Munitiz V, et al. Factors that affect recurr-ence after incisional herniorrhaphy with prosthetic material. Eur J Surg, 2001, 167(11):855-859.
4.	Abdollahi A, Maddah GH, Mehrabi BM, et al. Prosthetic incisional hernioplasty:clinical experience with 354 cases. Hernia, 2010, 14(6):569-573.
5.	Henriksen NA, Yadete DH, Sorensen LT, et al. Connective tissue alteration in abdominal wall hernia. Br J Surg, 2011, 98(2):210-219.
6.	Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, et al. Recurrences after laparoscopic repair of ventral and incisional hernia:lessons learned from 505 repairs. Surg Endosc, 2009, 23(4):825-832.
7.	White B, Osier C, Gletsu N, et al. Abnormal primary tissue collagen composition in the skin of recurrent incision hernia patients. Am Surg, 2007, 73(12):1254-1258.
8.	Calaluce R, Davis JW, Bachman SL, et al. Incisional hernia recurr-ence through genomic profiling:a pilot study. Hernia, 2012 May 31.[Epub ahead of print].
9.	华烨, 韩继明, 王灿, 等.不同缝线实施无张力疝修补术的临床对比研究.中国普外基础与临床杂志, 2013, 20(1):82-84.
10.	Webb D, Stoikes N, Voeller G. Evolution of mesh fixation for hernia repair. Surg Technol Int, 2014, 11(25):123-129.
11.	Andersen LP, Klein M, Gögenur I, et al. Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique. BMC Surg, 2009, 9:6.
12.	Israelsson LA, Smedberg S, Montgomery A, et al. Incisional hernia repair in Sweden 2002. Hernia, 2006, 10(3):258-261.
13.	Bröker M, Verdaasdonk E, Karsten T. Components separation technique combined with a double-mesh repair for large midline incisional hernia repair. World J Surg, 2011, 35(11):2399-2402.
14.	Hawn MT, Snyder CW, Graham LA, et al. Long-term follow-up of technical outcomes for incisional hernia repair. J Am Coll Surg, 2010, 210(5):648-657.
15.	刘飞德, 王世斌, 朱瑛梅, 等.腹壁切口疝补片修补术后复发的再手术治疗.中国普外基础与临床杂志, 2012, 19(3):300-304.
16.	Sanchez VM, Abi-Haidar YE, Itani KM. Mesh infection in ventral incisional hernia repair:incidence, contributing factors, and treatment. Surg Infect (Larchmt), 2011, 12(3):205-210.
17.	申英末, 陈杰.切口疝.北京:人民军医出版社, 2011:97-98.
18.	Sturt NJ, Liao CC, Engledow AH, et al. Results of laparoscopic repair of primary and recurrent incisional hernias at a single UK institution. Surg Laparosc Endosc Percutan Tech, 2011, 21(2):86-89.
19.	Motson RW, Engledow AH, Medhurst C, et al. Laparoscopic incisional hernia repair with a self-centring suture. Br J Surg, 2006, 93(12):1549-1553.
20.	Deerenberg EB, Timmermans L, Hogerzeil DP, et al. A systematic review of the surgical treatment of large incisional hernia. Hernia, 2015, 19(1):89-101.
21.	中华医学会外科学分会内分泌外科学组, 中华医学会外科学分会腹腔镜与内镜外科学组, 中华医学会外科学分会胃肠外科学组, 等.中国肥胖病外科治疗指南(2007).中国实用外科杂志, 2007, 27(10):759-762.
22.	Chan G, Chan CK. A review of incisional hernia repairs:preopera-tive weight loss and selective use of the mesh repair. Hernia, 2005, 9(1):37-41.
23.	Sauerland S, Korenkov M, Kleinen T, et al. Obesity is a risk factor for recurrence after incisional hernia repair. Hernia, 2004, 8(1):42-46.
24.	George CD, Ellis H. The results of incisional hernia repair:a twelve-year review. Ann Roy Coll Surg, 1986, 68:185.
25.	Patti R, Caruso AM, Aiello P, et al. Acute inflammatory response in the subcutaneous versus periprosthethic space after incisional hernia repair:an original article. BMC Surg, 2014, 14:91.

1. Fink C, Baumann P, Wente MN, et al. Incisional hernia rate 3 years after midline laparotomy. Br J Surg, 2014, 101(2):51-54.
2. Vidović D, Jurisić D, Franjić BD, et al. Factors affecting recurrence after incisional hernia repair. Hernia, 2006, 10(4):322-325.
3. Rios A, Rodriguez JM, Munitiz V, et al. Factors that affect recurr-ence after incisional herniorrhaphy with prosthetic material. Eur J Surg, 2001, 167(11):855-859.
4. Abdollahi A, Maddah GH, Mehrabi BM, et al. Prosthetic incisional hernioplasty:clinical experience with 354 cases. Hernia, 2010, 14(6):569-573.
5. Henriksen NA, Yadete DH, Sorensen LT, et al. Connective tissue alteration in abdominal wall hernia. Br J Surg, 2011, 98(2):210-219.
6. Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, et al. Recurrences after laparoscopic repair of ventral and incisional hernia:lessons learned from 505 repairs. Surg Endosc, 2009, 23(4):825-832.
7. White B, Osier C, Gletsu N, et al. Abnormal primary tissue collagen composition in the skin of recurrent incision hernia patients. Am Surg, 2007, 73(12):1254-1258.
8. Calaluce R, Davis JW, Bachman SL, et al. Incisional hernia recurr-ence through genomic profiling:a pilot study. Hernia, 2012 May 31.[Epub ahead of print].
9. 华烨, 韩继明, 王灿, 等.不同缝线实施无张力疝修补术的临床对比研究.中国普外基础与临床杂志, 2013, 20(1):82-84.
10. Webb D, Stoikes N, Voeller G. Evolution of mesh fixation for hernia repair. Surg Technol Int, 2014, 11(25):123-129.
11. Andersen LP, Klein M, Gögenur I, et al. Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique. BMC Surg, 2009, 9:6.
12. Israelsson LA, Smedberg S, Montgomery A, et al. Incisional hernia repair in Sweden 2002. Hernia, 2006, 10(3):258-261.
13. Bröker M, Verdaasdonk E, Karsten T. Components separation technique combined with a double-mesh repair for large midline incisional hernia repair. World J Surg, 2011, 35(11):2399-2402.
14. Hawn MT, Snyder CW, Graham LA, et al. Long-term follow-up of technical outcomes for incisional hernia repair. J Am Coll Surg, 2010, 210(5):648-657.
15. 刘飞德, 王世斌, 朱瑛梅, 等.腹壁切口疝补片修补术后复发的再手术治疗.中国普外基础与临床杂志, 2012, 19(3):300-304.
16. Sanchez VM, Abi-Haidar YE, Itani KM. Mesh infection in ventral incisional hernia repair:incidence, contributing factors, and treatment. Surg Infect (Larchmt), 2011, 12(3):205-210.
17. 申英末, 陈杰.切口疝.北京:人民军医出版社, 2011:97-98.
18. Sturt NJ, Liao CC, Engledow AH, et al. Results of laparoscopic repair of primary and recurrent incisional hernias at a single UK institution. Surg Laparosc Endosc Percutan Tech, 2011, 21(2):86-89.
19. Motson RW, Engledow AH, Medhurst C, et al. Laparoscopic incisional hernia repair with a self-centring suture. Br J Surg, 2006, 93(12):1549-1553.
20. Deerenberg EB, Timmermans L, Hogerzeil DP, et al. A systematic review of the surgical treatment of large incisional hernia. Hernia, 2015, 19(1):89-101.
21. 中华医学会外科学分会内分泌外科学组, 中华医学会外科学分会腹腔镜与内镜外科学组, 中华医学会外科学分会胃肠外科学组, 等.中国肥胖病外科治疗指南(2007).中国实用外科杂志, 2007, 27(10):759-762.
22. Chan G, Chan CK. A review of incisional hernia repairs:preopera-tive weight loss and selective use of the mesh repair. Hernia, 2005, 9(1):37-41.
23. Sauerland S, Korenkov M, Kleinen T, et al. Obesity is a risk factor for recurrence after incisional hernia repair. Hernia, 2004, 8(1):42-46.
24. George CD, Ellis H. The results of incisional hernia repair:a twelve-year review. Ann Roy Coll Surg, 1986, 68:185.
25. Patti R, Caruso AM, Aiello P, et al. Acute inflammatory response in the subcutaneous versus periprosthethic space after incisional hernia repair:an original article. BMC Surg, 2014, 14:91.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Multivariate Analysis of Recurrence of Incisinonal Hernia Following Incisional Hernia Tension-Free Repair

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