title: Chronic complaints after simple sutured repair for umbilical or epigastric hernias may be related to recurrence.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Gastrounit, Surgical Divison, Hvidovre University Hospital, Kettegård Alle 30, 2650, Hvidovre, Denmark.
authors.forename: Mikkel
authors.initials: M
authors.lastname: Westen
authors.forename: Mette W
authors.initials: MW
authors.lastname: Christoffersen
authors.forename: Lars N
authors.initials: LN
authors.lastname: Jorgensen
authors.forename: Trine
authors.initials: T
authors.lastname: Stigaard
authors.forename: Thue
authors.initials: T
authors.lastname: Bisgaard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000601:surgery*; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D055815:Young Adult
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