Table 1 Contributors to recurrence rate (RR) in umbilical hernia repair
From: Umbilical hernia repair and recurrence: need for a clinical trial?
Author | Study design and (n = 4363) | Contributing factor | Conclusion |
|---|---|---|---|
Christofferson (2015) | Cohort Study N = 1313 | Use of mesh versus primary repair | Overall RR 10% with mesh and 21% for primary suture repair (p = 0.001) |
Cheng (2018) | Cohort Study N = 168 | use of a mesh ventral patch | RR 2.4% and SSI rate of 4.7%. When Intraperitoneal placement of mesh performed SSI was 19% |
Donovan (2019) | Cohort Study N = 979 | Age, sex, body mass index, concurrent laparoscopic inguinal hernia repair, smoking status, diabetes, postoperative infection, hernia size, type of repair | RR of 3.3%. Higher BMI (p = 0.007), concurrent laparoscopic inguinal hernia repair (p = 0.044), current smoking (p = 0.020), diabetes (p = 0.021), and primary closure repair of hernias > 1.5 cm (p = 0.001) had a greater risk of recurrence |
Froylich (2016) | Cohort study N = 186 | Laparoscopic versus open repair | RR in the laparoscopic was 20% vs. 27.1% for open (p = 0.28) |
Kauffman (2018) | Randomized Control Trial N = 300 | Use of Mesh versus Primary Repair | RR in mesh 3·6% [95% CI 1·4–9·4] vs 11·4% (6·8–18·9) in suture repair (p = 0.01) |
Mitura (2017) | Cohort Study N = 82 | Closure of defect (IPOM plus) versus bridging mesh (IPOM) | IPOM plus had no recurrence vs. 10% RR for standard IPOM (p = 0.018) |
Ponten (2019) | Randomized control trial = 352 | Mesh ventral patch (PVP) versus standard prolene mesh | No significant differences were seen in RR (n = 13, 8.4% PVP vs n = 6, 4.1% mesh (p = 0.127) |
Shankar (2017) | Cohort study N = 332 | Use Mesh versus Primary repair and multiple other demographic factors | Ascites, liver disease, diabetes, obesity, and primary suture repair were significantly with RR. Primary suture RR 9.8% vs. 2.4% in mesh (p = 0.04) |
Winsnes (2016) | Cohort Study N = 306 | Use of Mesh versus Primary Repair | RR of 8.4% (8% mesh v 9% suture OR 0.90, 95% CI 0.40–2.02) Complication rate was significantly higher in patients receiving mesh repair OR 6.63, 95% CI 2.29–20.38. Coexisting hernia OR 2.84, 95% CI 1.24–6.48 |
Yao (2016) | Cohort Study N = 199 | Primary Suture repair in obese patients | RR obese vs. non-obese not significantly different 3.7% vs 4.6%, (p = 5.72). BMI no association with complications |