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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Umbilical hernia: Factors indicative of recurrence

Department of Surgery, Kaunas University of Medicine, Lithuania
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Author to whom correspondence should be addressed.
Medicina 2008, 44(11), 855; https://doi.org/10.3390/medicina44110108
Received: 9 May 2008 / Accepted: 7 November 2008 / Published: 12 November 2008
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Abstract

Umbilical hernia has gained little attention from surgeons in comparison with other types of abdominal wall hernias (inguinal, postoperative); however, the primary suture for umbilical hernia is associated with a recurrence rate of 19–54%. The aim of this study was to analyze the results of the umbilical hernia repair and to assess the independent risk factors influencing umbilical hernia recurrence.
Materials and methods
. A retrospective analysis of patients who underwent surgery for umbilical hernia in the Hospital of Kaunas University of Medicine in 2001–2006 was performed. Age, sex, hospital stay, hernia size, patient’s body mass index, and postoperative complications were analyzed. Postoperative evaluation included pain and discomfort in the abdomen and hernia recurrence rate. The questionnaire, which involved all these previously mentioned topics, was sent to all patients by mail. Hernia recurrence was diagnosed during the patients’ visit to a surgeon. Two surgical methods were used to repair umbilical hernia: open suture repair technique (keel technique) and open mesh repair technique (onlay technique). Every operation was chosen individually by a surgeon.
Results. Ninety-seven patients (31 males and 66 females) with umbilical hernia were examined. The mean age of the patients was 57.1±15.4 years, hernia anamnesis – 7.6±8.6 years, hospital stay – 5.38±3.8 days. Ninety-two patients (94.8%) were operated on using open suture repair technique and 5 (5.2%) patients – open mesh repair technique. Only 7% of patients whose BMI was >30 kg/m2 and hernia size >2 cm and 4.3% of patients whose BMI was <30 kg/m2 and hernia size <2 cm were operated on using onlay technique (P>0.05). The rate of postoperative complications was 5.2%. Sixty-seven patients (69%) answered the questionnaire. The complete patient’s recovery time after surgery was 2.4±3.4 months. Fourteen patients (20.9%) complained of pain or discomfort in the abdomen, and 7 patients (10.4%) had ligature fistula after the surgery. Forty-five patients (67.2%) did not have any complaints after surgery. The recurrence rate after umbilical hernia repair was 8.9%. The recurrence rate was higher when hernia size was >2 cm (9% for <2 cm vs 10.5% for >2 cm) and patient’s BMI was >30 kg/m2 (8.6% for < 30 vs 10.7% for >30). There were 5 recurrence cases after open suture repair and one case after onlay technique. Fifty-six patients (83.6%) assessed their general condition after surgery as good, 9 patients (13.4%) as satisfactory, and only 2 patients (3%) as poor.
Conclusions.
We did not find any significant independent risk factors for umbilical hernia recurrence. However, based on reviewed literature, higher patient’s body mass index and hernia size of >2 cm could be the risk factors for umbilical hernia recurrence.
Keywords: umbilical hernia; recurrence rate; mesh repair; suture repair umbilical hernia; recurrence rate; mesh repair; suture repair
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Venclauskas, L.; Šilanskaitė, J.; Kiudelis, M. Umbilical hernia: Factors indicative of recurrence. Medicina 2008, 44, 855.

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