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Hernia

Open Access 25-09-2024 | Incisional Hernia | Original Article

Evaluation of risk factors associated with the peritoneal flap hernioplasty for complex incisional hernia repair - a retrospective review of 327 cases

Authors: Kristian Als Nielsen, Bruce Tulloh, Andrew de Beaux, Andreas Kristian Pedersen, Sofie Ronja Petersen, Brandur Jogvansson, Mark Bremholm Ellebaek, Alexandros Valsamidis, Ayat Allah Alnabhan, Per Helligsø, Michael Festersen Nielsen

Published in: Hernia

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Abstract

Background

Repair of large incisional hernias is challenging, and the risks of postoperative complications have been associated with obesity, smoking, and diabetes. The present study was conducted to determine the impact of these risk factors on short and long-term outcomes following the repair with the peritoneal flap hernioplasty (PFH).

Methods

Three hundred twenty-seven patients undergoing PFH for incisional hernia repair were identified. Patient demographics and clinical data were recorded. Patients presenting signs of complications were assessed during a visit to the outpatient clinic. A multivariable regression analysis was performed to evaluate the association between BMI, smoking and diabetes, and postoperative complications.

Results

The study included 157 males (48.0%) and 170 females (52.0%). Median BMI was 30.9 kg/m2. Diabetes was present in 13.8% of patients. 23.2% were active smokers. The recurrence rate was 2.4%. The odds ratios for postoperative complications were increased by 9% per BMI unit (P < 0.01), due predominantly to a rise in superficial wound infections (P < 0.01) and seroma production (P = 0.07). The adjusted odds ratio increased fourfold in patients with BMI > 40 kg/m2 (P = 0.06).

Conclusion

Incisional hernia repair with the PFH technique is associated with a low risk of short and long-term complications. The risk is associated with obesity and significantly increased in patients with a BMI exceeding 40 kg/m2, where a fourfold increase was observed predominantly due to seroma and superficial wound infections. The recurrence rate was 2.4% and was unaltered across BMI categories. No association was established between smoking, diabetes, and the risk of all-cause complications.
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Metadata
Title
Evaluation of risk factors associated with the peritoneal flap hernioplasty for complex incisional hernia repair - a retrospective review of 327 cases
Authors
Kristian Als Nielsen
Bruce Tulloh
Andrew de Beaux
Andreas Kristian Pedersen
Sofie Ronja Petersen
Brandur Jogvansson
Mark Bremholm Ellebaek
Alexandros Valsamidis
Ayat Allah Alnabhan
Per Helligsø
Michael Festersen Nielsen
Publication date
25-09-2024
Publisher
Springer Paris
Published in
Hernia
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-024-03162-1
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