Long-term follow-up (at 5years) of midline incisional hernia repairs using a primary closure and prosthetic onlay technique: recurrence and quality of life.

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The recurrence rate of incisional hernia (IH) repair is usually underestimated due to a lack of long-term follow-up. The objective of this study was to evaluate recurrence rate for patients operated on midline IH surgery, using a primary closure and prosthetic onlay technique, 5years after the procedure. From January 2009 to January 2011, all 92 patients operated on elective midline IH repair by primary closure and prosthetic onlay technique in a General Surgery Department were retrospectively included in the study. Exclusion criteria were absence of follow-up or death. Recurrence rate and quality of life were assessed. Demographic, surgical data and quality of life in patients with and without 5-year recurrence were compared. Mean follow-up was 64months. Ultimately, 76 patients were included in the study, representing 82% of the selected patients during the study period (76/92), of whom 24 presented a recurrence (32%). Half (12) were diagnosed for recurrence more than 3years after the surgery. Patients who developed a recurrence had more percentage of obesity (64 vs. 29%, p=0.016), which denoted an odds ratio (OR) for recurrence of 4.4 (1.2-15.7; p=0.01) and they punctuated lower in quality of life (6.0±2.9 vs. 7.6±2.6, p=0.006). Recurrence rate on midline IH repair is still a concern (32% at 5years). It is advisable to look for other strategies and more efficient surgical techniques for IH surgery, especially in obese patients.