Chronic complaints after simple sutured repair for umbilical or epigastric hernias may be related to recurrence

Abstract

Umbilical and epigastric hernia repairs are minor, but are commonly conducted surgical procedures. Long-term results have only been sparsely investigated. Our objective was to investigate the risk of chronic complaints after a simple sutured repair for small umbilical and epigastric hernias. A retrospective cohort study with a 5-year questionnaire and clinical follow-up was conducted. Patients undergoing primary elective, open non-mesh umbilical or epigastric sutured hernia repair were included. Patients completed a structured questionnaire regarding chronic complaints during work and leisure activities using a verbal rating scale. The primary outcome was chronic complaints. A total of 295 patients were included for analysis after a median of 5.0-year (range 2.8-8.0) follow-up period. Follow-up results were achieved from 262 of the included patients (90% response rate). Up till 5.8% of the patients reported moderate or severe pain and discomfort. Work and leisure activities were restricted in 8.5 and 10.0% of patients, respectively. Patients with chronic complaints had a higher incidence of recurrence (clinical and reoperation), than patients with none or mild complaints (78.6 vs. 22.2% (P < 0.001)). The recurrence rate was significantly higher after a repair with absorbable suture (20.1%) compared with non-absorbable suture repair (4.2%) (P < 0.001). We found that chronic complaints after a simple sutured umbilical or epigastric repair was in the level of 5.5% and could in part be explained by recurrence. Furthermore, absorbable suture should be omitted to reduce risk of recurrence.