A nationwide study on readmission, morbidity, and mortality after umbilical and epigastric hernia repair

Abstract

Background: Repair for umbilical and epigastric hernia is a minor and common surgical procedure. Early outcomes are not well documented.

Methods: All patients ≥18 years operated on for umbilical or epigastric hernia in Denmark during a 2-year period (2005-2006) were analysed according to hospital stay, risk of readmission, complications, and mortality <30 days after operation. Patients with acute operations and patients having an umbilical and epigastric hernia repair secondary to other surgical procedures were excluded. Results were based on data from the National Patient Registry.

Results: A total 3,431 operations (open repairs 3,165; laparoscopic repairs 266) in 3,383 patients were performed. The median hospital stay was 0 day (range 0-61 days) (open 0 day; laparoscopic 1 day); 75% stayed in hospital for 0 days, 20% for 1 day and 5% > 1 day. Readmissions occurred in 5.3% of cases (open 4.9%; laparoscopic 10.5%). In the majority of patients readmissions were due to wound-related problems (haematoma, bleeding and/or infection) (46%), seroma (19%), or pain (7%). At 30 days, complications and mortality occurred in 4.1% (open 3.7%; laparoscopic 8.2%) and 0.1% (open 0.1%; laparoscopic 0.4%), respectively.

Conclusion: This first prospective nationwide study on elective umbilical and epigastric hernia repair found low morbidity and mortality but a high readmission rate mostly because of wound problems, seroma formation, or pain. Future research should focus on early outcomes in terms of wound problems, seroma formation, and pain after umbilical and epigastric hernia repair.