Factors that affect recurrence after incisional herniorrhaphy with prosthetic material

Abstract

Objective: To evaluate the risk factors for recurrence after prosthetic incisional herniorrhaphy. Design: Retrospective study Setting: Tertiary referral centre, Spain. Patients: 246 patients who had incisional herniorrhaphy with a prosthetic material (polypropylene) between 1990 and 1997 Interventions: A reinforcement mesh was inserted when the hernia was more than 5 cm. In incisional hernias less than 5 cm the reinforcement mesh was inserted when the repair was under tension or when tissues were noted to be weak during the operation. Main outcome measures: Age, sex, obesity, the presence of bronchial disease, previous repair of the incisional hernia, type of surgery, size and site of hernia and presence of local complications during the immediate postoperative period. Results: Mean (SD) follow-up was 77 (6) months (minimum follow up two years). The hernia recurred in 43 cases (17%) (mean time of recurrence 10 (8) months). Age over 60 years, previous herniorrhaphy, size of hernia, and postoperative local complications were significant risk factors (p < 0.01) in both the univariate and multivariate analyses. Conclusions: Patients at the greater risk of recurrence are those aged over 60 years, with large, recurrent hernias and who develop local complications during the postoperative period.