title: Umbilical hernia repair with mesh: identifying effectors of ideal outcomes.
abstract: BACKGROUND
  Quality of life has become an important focus for improvement in hernia repair.
  
  
  METHODS
  The International Hernia Mesh Registry was queried. The Carolinas Comfort Scale quantitated quality of life at 1-month, 6-month, and annual follow-up. Scores of 0 (completely asymptomatic) in all categories without recurrence defined an ideal outcome.
  
  
  RESULTS
  The analysis consisted of 363 umbilical hernia repairs; 18.7% were laparoscopic. Demographics included age of 51.5 ± 13.8 years, 24.5% were female, and the average body mass index was 30.63 ± 5.9 kg/m(2). Mean defect size was 4.3 ± 3.1 cm(2). Mean follow-up was 18.2 months. Absent/minimal preoperative symptoms were predictive of ideal outcome at all time points and increasing age was predictive at 6 months and 1 year. At 6 months, the use of fixation sutures alone versus tacks (odds ratio 14.1) predicted ideal outcome.
  
  
  CONCLUSIONS
  Ideal outcomes are dependent on both patient-specific and operative factors. The durable, ideal outcome in umbilical hernia repair is most likely in an older, asymptomatic patient who undergoes mesh fixation with permanent suture.
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Colavita
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Igor
authors.initials: I
authors.lastname: Belyansky
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Walters
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Alla Y
authors.initials: AY
authors.lastname: Zemlyak
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Lincourt
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Vedra.Augenstein@carolinas.org.
authors.forename: Vedra A
authors.initials: VA
authors.lastname: Augenstein
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012008:Recurrence; D012042:Registries; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: Carolinas Comfort Score; Laparoscopic umbilical hernia repair; Mesh; Open umbilical hernia repair; Quality of life; Umbilical hernia