Umbilical hernia repair with mesh: identifying effectors of ideal outcomes

Am J Surg. 2014 Sep;208(3):342-9. doi: 10.1016/j.amjsurg.2013.12.031. Epub 2014 Apr 3.

Abstract

Background: Quality of life has become an important focus for improvement in hernia repair.

Methods: The International Hernia Mesh Registry was queried. The Carolinas Comfort Scale quantitated quality of life at 1-month, 6-month, and annual follow-up. Scores of 0 (completely asymptomatic) in all categories without recurrence defined an ideal outcome.

Results: The analysis consisted of 363 umbilical hernia repairs; 18.7% were laparoscopic. Demographics included age of 51.5 ± 13.8 years, 24.5% were female, and the average body mass index was 30.63 ± 5.9 kg/m(2). Mean defect size was 4.3 ± 3.1 cm(2). Mean follow-up was 18.2 months. Absent/minimal preoperative symptoms were predictive of ideal outcome at all time points and increasing age was predictive at 6 months and 1 year. At 6 months, the use of fixation sutures alone versus tacks (odds ratio 14.1) predicted ideal outcome.

Conclusions: Ideal outcomes are dependent on both patient-specific and operative factors. The durable, ideal outcome in umbilical hernia repair is most likely in an older, asymptomatic patient who undergoes mesh fixation with permanent suture.

Keywords: Carolinas Comfort Score; Laparoscopic umbilical hernia repair; Mesh; Open umbilical hernia repair; Quality of life; Umbilical hernia.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Hernia, Umbilical / surgery*
  • Herniorrhaphy* / instrumentation
  • Herniorrhaphy* / methods
  • Humans
  • Laparoscopy
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Quality of Life
  • Recurrence
  • Registries
  • Surgical Mesh*
  • Treatment Outcome