title: A consecutive series of 235 epigastric hernias.
abstract: BACKGROUND
  Epigastric herniation is a common, though not always symptomatic condition. It is likely, that in accordance to the tension-free principles for other hernias, epigastric hernia repair should be mesh based.
  
  
  METHODS
  Patients from two large hospitals were investigated retrospectively if they were operated on an epigastric hernia for the past 6 years. Follow-up was completed with a postal questionnaire.
  
  
  RESULTS
  A total of 235 patients (50 % male) were operated. Sixty-eight patients were operated with mesh and 167 patients with suture repair. Forty-six patients were loss-to follow-up (19.6 %). In the mesh operated patients the recurrence rate was 10.9 % (n = 6) compared to 14.9 % (n = 20) in the suture repair group. Cox-regression analysis showed an increased risk for recurrence in the suture repair group (odds ratio 1.43; 95 % CI 0.56-3.57; p = 0.44). Operation time for mesh repair (47 min) was significantly longer compared to suture repair (29 min) (p < 0.0001). Thirty-seven patients had previous or other anterior wall hernias. A total of 51 patients smoked and 14 patients had diabetes mellitus. Fourteen patients used steroids and 22 patients suffered from a chronic lung disease. Subgroup analysis showed a significant difference for pain in patients in which re-operation for a recurrence occurred (p = 0.004).
  
  
  CONCLUSIONS
  This is one of the largest reported series on solely epigastric hernias. A recurrence occurred more often after sutured repair compared to mesh repair. No differences in chronic pain was seen between mesh and suture repaired patients. Male:female ratio of 1:1, which is different from the 3:1 ratio found in previous older smaller studies, could be more reliable.
authors: Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. jeroen.ponten@catharina-ziekenhuis.nl.
authors: J E H
authors: JE
authors: Ponten
authors: Department of Surgery, Maxima Medical Center Veldhoven/Eindhoven, Eindhoven, The Netherlands.
authors: B J M
authors: BJ
authors: Leenders
authors: Department of Surgery, Maxima Medical Center Veldhoven/Eindhoven, Eindhoven, The Netherlands.
authors: J A
authors: JA
authors: Charbon
authors: Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
authors: S W
authors: SW
authors: Nienhuijs
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D013537:Sutures
keywords: Epigastric hernia; Mesh herniorrhaphy; Mesh repair; Primary repair; Suture herniorrhaphy