| 1. |
- Israelsson, Leif A, et al.
(author)
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Incisional hernia repair in Sweden 2002
- 2006
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In: Hernia. - : Springer. - 1265-4906 .- 1248-9204. ; 10:3, s. 258-261
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Journal article (peer-reviewed)abstract
- Incisional hernia is a common problem after abdominal surgery. The complication and recurrence rates following the different repair techniques are a matter of great concern. Our aim was to study the results of incisional hernia repair in Sweden. A questionnaire was sent to all surgical departments in Sweden requesting data concerning incisional hernia repair performed during the year 2002. Eight hundred and sixty-nine incisional hernia repairs were reported from 40 hospitals. Specialist surgeons performed the repair in 782 (83.8%) patients. The incisional hernia was a recurrence in 148 (17.0%) patients. Thirty-three per cent of the hernias were subsequent to transverse, subcostal or muscle-splitting incisions or laparoscopic procedures. Suture repair was performed in 349 (40.2%) hernias. Onlay mesh repair was more common than a sublay technique. The rate of wound infection was 9.6% after suture repair and 8.1% after mesh repair. The recurrence rate was 29.1% with suture repair, 19.3% with onlay mesh repair, and 7.3% with sublay mesh repair. This survey revealed that there is room for improvement regarding the incisional hernia surgery in Sweden. Suture repair, with its unacceptable results, is common and mesh techniques employed may not be optimal. This study has led to the instigation of a national incisional hernia register.
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| 2. |
- Lundström, Karl-Johan, et al.
(author)
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Risk factors for complications in Groin Hernia surgery : A National register study
- 2012
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In: Annals of Surgery. - Philasdelphia, PA, USA : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 255:4, s. 784-788
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Journal article (peer-reviewed)abstract
- Objective: This study aims to analyze and identify risk factors for postoperative complications and analyze the relative risk of reoperation for recurrence for respective complication. Background: The outcome of groin hernia surgery is evaluated mostly by comparing recurrence rates and long-term pain. The aim of this observational population-based registry study was to identify risk factors for postoperative complications and analyze the relative risk of reoperation for recurrence for respective complication. Methods: Using data from the nationwide Swedish Hernia Register between 1998 and 2009, 150,514 herniorrhaphies were analyzed with respect to postoperative complications occurring within 30 days of surgery. Results: Risk factors significantly affecting the rate of postoperative complications were laparoscopic repair (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.24-1.47) and open preperitoneal techniques (OR: 1.31, 95% CI: 1.15-1.49), with open anterior mesh as reference category. Other significant risk factors were general (OR: 1.30, 95% CI: 1.23-1.37) and regional anesthesia (OR: 1.53, 95% CI: 1.43-1.63), with local anesthesia as reference category, emergency procedures (OR: 1.53, 95% CI: 1.43-1.63); recurrent hernia repair (OR: 1.39, 95% CI: 1.27-1.52); femoral hernia (OR: 1.30, 95% CI: 1.14-1.48); aged older than 65 years (OR: 1.26, 95% CI: 1.21-1.31); and duration of surgery exceeding 50 minutes (OR: 1.27, 95% CI: 1.22-1.33). Conclusions: Open anterior approach and surgery under local anesthesia are associated with less risk of postoperative complications.
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| 3. |
- Magnusson, Niklas, 1975-, et al.
(author)
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Reoperation for chronic pain after groin hernia surgery : a population-based study
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Other publication (other academic/artistic)abstract
- Introduction:Evidence supporting any one technique used at reoperation for chronic pain after hernia surgery is lacking.Materials and methods:All patients who had undergone surgery for chronic pain after previous groin hernia surgery 1999-2006 were identified in the Swedish Hernia Register (n=237). Data on the surgical technique used were abstracted from the medical records. The patients were asked to answer a set of questions including SF-36, the Inguinal Pain Questionnaire (IPQ) and other questions in order to evaluate the prevalence of pain after reoperation.Results:The study group consisted of 95 males and 16 females, mean age 53 years. Continued pain after reoperation was present in 19 %. In 27 % of cases an intervention aimed at suspected ilioinguinal neuralgia was performed. The mesh was removed completely in 28 % and partially in 13 %. A suture at the pubic tubercle was removed in 13 % of cases.Decrease in pain after the most recent reoperation was reported by 69 patients (62%), no change in pain by 21 patients (19%) and increase in pain in 21 patients (19%). There was no significant difference in outcome between the techniques applied.Conclusion:Patients reoperated for chronic pain after hernia surgery often report a reduction in pain, but the natural course of chronic pain and selection of patients makes it difficult to draw any definite conclusions.
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| 4. |
- Rogmark, Peder, et al.
(author)
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Long-Term Follow-Up of Retromuscular Incisional Hernia Repairs : Recurrence and Quality of Life
- 2018
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In: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 42:4, s. 974-980
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Journal article (peer-reviewed)abstract
- Purpose: Incisional hernia repair (IHR) with a mesh is necessary to achieve low recurrence rates and pain relief. In the short term, quality of life (QoL) is restored by IHR. Two centers pioneered the IHR in Sweden with the highly standardized Rives–Stoppa technique using a retromuscular mesh. We assessed long-term follow-up of recurrence rate and QoL. Methods: Medical records were searched for IHRs performed from 1998 to 2006 and included living patients with midline repairs. Questionnaires about physical status, complaints, and QoL (SF-36) were mailed, offering a clinical examination. Assessment of medical records of later surgery was performed in 2015. Results: Three hundred and one patients with midline incisional repairs were identified, and 217 accepted participation. Of these, 103 attended a clinical examination. Follow-up was 7 years until examination and 11 years to reassessment of medical records. In 26%, recurrent hernias were repaired. Postoperative complications were 26% Clavien–Dindo grade I–II and 1% grade III–IV. Mesh infections occurred in 1.4% without mesh removals, and 4% were reoperated because of complications. Overall recurrence rate was 8.1% and two-third of which were diagnosed at clinical examination. Recurrence after primary and recurrent hernia repair was 7.1 and 10.9%, respectively. Of all patients, 80% were satisfied; dissatisfaction was primarily caused by recurrence and chronic pain. SF-36 scores were 0.2 SD lower than the norm in all subscales, similar to those with 1–2 chronic conditions. Conclusions: Midline retromuscular mesh IHR has a low long-term recurrence rate even after recurrent repair. Patient satisfaction was high although QoL was reduced.
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| 5. |
- Rogmark, Peder, et al.
(author)
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Short-term outcomes for open and laparoscopic midline incisional hernia repair : a randomized multicenter controlled trial
- 2013
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In: Annals of Surgery. - 0003-4932 .- 1528-1140. ; 258:1, s. 37-45
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Journal article (peer-reviewed)abstract
- OBJECTIVE: : The aim of the trial was to compare laparoscopic technique with open technique regarding short-term pain, quality of life (QoL), recovery, and complications.BACKGROUND: : Laparoscopic and open techniques for incisional hernia repair are recognized treatment options with pros and cons.METHODS: : Patients from 7 centers with a midline incisional hernia of a maximum width of 10 cm were randomized to either laparoscopic (LR) or open sublay (OR) mesh repair. Primary end point was pain at 3 weeks, measured as the bodily pain subscale of Short Form-36 (SF-36). Secondary end points were complications registered by type and severity (the Clavien-Dindo classification), movement restrictions, fatigue, time to full recovery, and QoL up to 8 weeks.RESULTS: : Patients were recruited between October 2005 and November 2009. Of 157 randomized patients, 133 received intervention: 64 LR and 69 OR. Measurements of pain did not differ, nor did movement restriction and postoperative fatigue. SF-36 subscales favored the LR group: physical function (P < 0.001), role physical (P < 0.012), mental health (P < 0.022), and physical composite score (P < 0.009). Surgical site infections were 17 in the OR group compared with 1 in the LR group (P < 0.001). The severity of complications did not differ between the groups (P < 0.213).CONCLUSIONS: : Postoperative pain or recovery at 3 weeks after repair of midline incisional hernias does not differ between LR and OR, but the LR results in better physical function and less surgical site infections than the OR does. (ClinicalTrials.gov Identifier: NCT00472537).
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