Outcome of incisional hernia repair in patients with Inflammatory Bowel Disease

Abstract

Background: Incisional Hernia (IH) repair in patients with Inflammatory Bowel Disease (IBD) has not been well studied.

Methods: Outcomes of 170 patients with IBD who underwent IH repair were included in the study.

Results: The incidence of recurrence after IH repair in IBD is 27%. Patients with Crohn's disease (CD) had larger defects at the time of repair, higher proportion of bowel resection and a longer postoperative stay when compared to Ulcerative colitis (UC). The only significant predictor of recurrence after IH repair was the number of previous bowel resections prior to hernia repair (HR 1.59, p < 0.01). Three cases (10%) of late onset enterocutaneous fistulas were identified in patients who underwent IH repair with synthetic mesh inlay.

Conclusion: Surgical repair results in a recurrence of IH in 27% of patients with IBD. The number of previous bowel resections is the only factor that correlates with development of recurrent IH in IBD.

Keywords: Crohn's disease; Enterocutaneous fistula; Hernia recurrence; Incisional hernia; Mesh repair; Ulcerative colitis.