Recurrence and pseudorecurrence after laparoscopic ventral hernia repair: predictors and patient-focused outcomes.
Laparoscopic ventral hernia repair (LVHR) is gaining popularity as an option to repair abdominal wall hernias. Bulging after repair remains common after this technique. This study evaluates the incidence and factors associated with bulging after LVHR. Between 2000 and 2010, 201 patients underwent LVHR at two affiliated institutions. Patients who developed recurrence or pseudorecurrence (seroma or eventration) were analyzed with univariate and multivariate analyses to identify predictors of these complications. Of the 201 patients who underwent LVHR, 40 (19.9%) patients developed a seroma, 63 (31.3%) patients had radiographically proven eventration, and 25 (12.4%) patients had a hernia recurrence. On multivariate analysis, seromas were associated with number of prior ventral hernia repairs, surgical site infections, and prostate disease. Mesh eventration was associated with hernia size and surgical technique. Tissue eventration was associated with primary hernias and surgical technique. Hernia recurrence was associated with incisional hernias and mesh type used. Recurrence and pseudorecurrence are important complications after LVHR. Large hernia size, infections, and surgical technique are important clinical factors that affect outcomes after LVHR.
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
Stacey A
SA
Carter
Stephanie C
SC
Hicks
Reshma
R
Brahmbhatt
Mike K
MK
Liang
D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D049291:Seroma / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013526:Surgical Mesh / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome