Long-term recurrence and chronic pain after repair for small umbilical or epigastric hernias: a regional cohort study

Abstract

Background: Mesh repair reduces the risk of reoperation for recurrence in patients with primary ventral hernias. However, reoperation for recurrence underestimates total recurrence (reoperation + clinical) and mesh reinforcement may induce chronic pain. This study investigated the total recurrence and risk of chronic pain in small primary ventral hernias.

Methods: A cohort study with questionnaire and clinical follow-up was conducted. Patients with primary, elective, open mesh or sutured repair for a small umbilical or epigastric hernia (≤ 2 cm) were included.

Results: One thousand three hundred thirteen patients completed the questionnaire. The total cumulated recurrence rate after primary repair was 10% for mesh repair and 21% for sutured repair (P = .001). The incidence of chronic pain was 6% after mesh repair and 5% after sutured repair (P = .711).

Conclusions: Mesh repair halved long-term risk of recurrence after repair for small ventral hernias without increased risk of chronic pain.

Keywords: Chronic pain; Mesh repair; Primary ventral hernia repair; Recurrence; Sutured repair.