Recurrence of Ventral Hernia Post Open Ventral Hernia Repair with Mesh and the Mechanism of Its Failure

Abstract

Aims: A ventral hernia is a protrusion of viscera through an abdominal wall defect. Ventral hernias are mostly treated by a surgical procedure called open ventral hernia repair (OVHR). However, complications arising from the OVHR procedure may result in the recurrence of a hernia. This study was aimed to measure the recurrence rate of ventral hernia after OVHR with mesh and the reasons for failure. Study Design: It was a cross-sectional retrospective study conducted on all patients who underwent an OVHR with mesh, between 2010 and 2017, at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Data were extracted from KAUH medical records. A total of 241 patients were included in the study, divided into two groups; group 1- patients with recurrence (37 patients) and group 2- patients with no recurrence (204 patients). Consent was taken from patients and preoperative assessment of procedures were performed under general anesthesia. The variables in the study are parameters like age, sex, parity, and history of chronic liver disease and their correlation with recurrence of the hernia. Different variables Data were analyzed by SPSS v 21. Association between the variables was determined using the t-test and Pearson’s Chi-squared tests. Results: The relationship between recurrence and age was statistically significant (P=0.019). The recurrence of hernia was more frequent in females than males. Patients with a history of multiparity (P=0.00) and liver diseases (P=0.041) showed significant differences in terms of recurrence. The umbilical hernia was more prevalent (133 cases; 55.2%) than other types of hernia. The most frequent site of hernia in the recurrence group was supraumbilical (38.46%; P=0.039). Conclusion: OVHR is a commonly performed surgical procedure at KAUH. Because of multiparity, ventral hernia recurrence was more common in women than men. To reduce recurrences, we recommend doing exercises to strengthen the abdominal muscles. Patients with chronic liver diseases in the form of portal hypertension should avoid surgical repair. For the surgeons, the type of mesh does not have a significant impact on recurrence.