title: Predictors of recurrence of umbilical hernias following primary tissue repair in obese veterans.
abstract: BACKGROUND
  Factors that determine recurrence and complications following primary tissue repair of umbilical hernias (UHs) and the approach to repair UHs in obese patients need further analysis.
  
  
  METHODS
  A retrospective review of UH repair (UHR) conducted at our institution was undertaken. Patients were grouped by body mass index (BMI) and compared for recurrence and complications. Univariate and multivariate analyses were performed.
  
  
  RESULTS
  In total, 199 patients (BMI 32.3 kg/m(2), 97% male, 77% Caucasian, American Society of Anesthesiologists class III/IV 59.2%) underwent primary tissue UHR. There were 8 recurrences (4.0%); average follow-up 3.9 ± 2.4 years (range 30 days to 9.2 years). There were no recurrences among normal BMI patients (0/11); 3 in overweight (3/54), 2 in class I obese (2/73), 2 in class II obese (2/47), and 1 in morbidly obese (1/14) patients (P = .84). Albumin and American Society of Anesthesiologists were similar in all groups. Recurrence rates among obese and nonobese patients were not significantly different (3.7% vs 4.6%, P = .72). There were 18 (9.0%) complications. BMI was not associated with complications.
  
  
  CONCLUSIONS
  Primary tissue repair is a feasible approach for UHR in obese patients.
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, USA.
authors.forename: Jie J
authors.initials: JJ
authors.lastname: Yao
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, USA.
authors.forename: Thai
authors.initials: T
authors.lastname: Pham
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: El Mokdad
authors.affiliation: Department of Surgery, University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, USA. Electronic address: Sergio.Huerta@UTSouthwestern.edu.
authors.forename: Sergio
authors.initials: S
authors.lastname: Huerta
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas; D016896:Treatment Outcome; D058014:Veterans Health
keywords: Incisional hernia; Laparoscopic hernia repair; Recurrent hernia; Ventral hernia