Incisional hernia recurrence following "vest-over-pants" or vertical Mayo repair of primary hernias of the midline.
A series of 68 primary midline incisional hernias with a vertical Mayo repair was evaluated retrospectively. Patients without documented hernia recurrence following this repair were invited for physical examination. Life-table methods were used for statistical analysis. The 1-, 3-, 5-, and 10-year cumulative recurrence rates were 35%, 46%, 48%, and 54%, respectively. Also, generally accepted risk factors were studied. Multivariate analysis identified the size of the hernia (p = 0.02) and the use of steroids (p = 0.04) as the most important independent risk factors of first time recurrent incisional hernia. Considering the high recurrence rates found, the results of this study strongly suggest that the vest-over-pants repair should no longer be used for closure of midline incisional hernias.
Luijendijk
R W
RW
Department of General Surgery, Leyenburg Hospital, Leyweg 275, 2545CH Den Haag, The Netherlands.
Lemmen
M H
MH
Hop
W C
WC
Wereldsma
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000379:methods