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4. Recurrence after elective incisional hernia repair is more frequent than you think: an international prospective cohort from the French Society of Surgery (AFC)

Author

Benoît Romain, Yohann Renard, Christine Binquet, Tigran Poghosyan, David Moszkowicz, Jean-François Gillion, Pablo Ortega-Deballon, Naziha Gadiri, Smain Mesli, Jean-Luc Bouillot, Christophe Mariette, Amélie Chau, Catherine Arvieux, Emeric Abet, Yohann Marion, Vincent Dubuisson, Anaelle David, Henry-Alexis Mercoli, Simone Manfredelli, Olivier Glehen, Guillaume Passot, Antoine Lamblin, Laurent Arnalsteen, Maita Constantin, Arthus Vauchaussade, Issam El Nakadi, Hassan Demian, Jean-Marc Régimbeau, Nicolas Demartines, Benoit Romain, Jean-Michel Chollet, Daniel Binot, Damien Massalou, Emmanuel Benizri, Virginie Pichot, Benjamin Blanc, Oussama Baraket, Florent Jurczak, Delphine Rouquié, Zeineb Mzoughi, Marc Soler, Jean-Baptiste Putinier, Jean-François Ain, Arnauld Bellouard, Muriel Mathonnet, Mohammed Najim, Edouard Vinatier, Marc Lepère, Olivier Cas, Jean-Pierre Cossa, Pascal Frileux, Dimitri Tzanis, Sandra Hennequin, Sebastien Demaret, Mustapha Merabet, Djaouad Bilem, Tayb Boukortt, Denis Blazquez, Eric Magne, Haitham Khalil, Claude Largenton, Marianne Lavy, Milène Isambert, Olivier Bréhant, Emmanuel Odet, Olivier Firtion, Jean-Luc Manouvrier, Jacques Soufron, Nathalie Letoux, Pôle des Pathologies Digestives Hépatiques et Transplantation [Hôpital Hautepierre-Strasbourg], Hôpital de Hautepierre [Strasbourg], Service de Chirurgie Digestive [CHU Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Ecole Supérieure Privée d'Ingénierie et de Technologies (ESPRIT), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Privé d'Antony, Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Participating surgeons' list: Jean-François Gillion, Pablo Ortega-Deballon, Naziha Gadiri, Smain Mesli, Tigran Poghosyan, David Moszkowicz, Jean-Luc Bouillot, Christophe Mariette, Amélie Chau, Catherine Arvieux, Emeric Abet, Yohann Renard, Yohann Marion, Vincent Dubuisson, Anaelle David, Henry-Alexis Mercoli, Simone Manfredelli, Olivier Glehen, Guillaume Passot, Antoine Lamblin, Laurent Arnalsteen, Maita Constantin, Arthus Vauchaussade, Issam El Nakadi, Hassan Demian, Jean-Marc Régimbeau, Nicolas Demartines, Benoit Romain, Jean-Michel Chollet, Daniel Binot, Damien Massalou, Emmanuel Benizri, Virginie Pichot, Benjamin Blanc, Oussama Baraket, Florent Jurczak, Delphine Rouquié, Zeineb Mzoughi, Marc Soler, Jean-Baptiste Putinier, Jean-François Ain, Arnauld Bellouard, Muriel Mathonnet, Mohammed Najim, Edouard Vinatier, Marc Lepère, Olivier Cas, Jean-Pierre Cossa, Pascal Frileux, Dimitri Tzanis, Sandra Hennequin, Sebastien Demaret, Mustapha Merabet, Djaouad Bilem, Tayb Boukortt, Denis Blazquez, Eric Magne, Haitham Khalil, Claude Largenton, Marianne Lavy, Milène Isambert, Olivier Bréhant, Emmanuel Odet, Olivier Firtion, Jean-Luc Manouvrier, Jacques Soufron, Nathalie Letoux, Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, and Ortega Deballon, Pablo

Subjects
Male, medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Lower risk, Odds, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Recurrence, medicine, Humans, Incisional Hernia, Hernia, Prospective Studies, Prospective cohort study, Herniorrhaphy, Aged, business.industry, Middle Aged, medicine.disease, 3. Good health, Surgery, Surgical mesh, Concomitant, Cohort, 030211 gastroenterology & hepatology, Female, France, business, Tomography, X-Ray Computed
Abstract

International audience; Background: The French Society of Surgery has endorsed a cohort aiming to prospectively assess the frequency of recurrence after incisional hernia repair and to identify the risk factors.Methods: Consecutive patients undergoing incisional hernia repair in the participating centers were included in the prospective French Society of Surgery cohort over a 6-month period. Patients were followed up with a computed tomography scan at 1 y and a clinical assessment by the surgeon at 2 years.Results: A total of 1,075 patients undergoing incisional hernia repair were included in 61 participating centers. The median follow-up was 24.0 months (interquartile range: 14.0-25.3). The follow-up rates were 83.0% and 68.5% at 1 and 2 years, respectively. The recurrence rates were 18.1% at 1 year and 27.7% at 2 years. Recurrence risk factors at 2 years were a history of hernia (odds ratio = 1.57, 95% confidence interval = 1.05-2.35, P = .028), a lateral hernia (odds ratio = 1.84, 95% confidence interval = 1.19-2.86, P = .007), a concomitant digestive operation (odds ratio = 1.97, 95% confidence interval = 1.20-3.22, P = .007), and the occurrence of early surgical site complications (odds ratio = 1,90, 95% confidence interval = 1.06-3.38, P = .030). The use of surgical mesh was strongly associated with a lower risk of recurrence at 2 years (P < .001).Conclusion: After incisional hernia repair, the 2-year recurrence rate is as high as 27.7%. History of hernia, lateral hernia, concomitant digestive operation, the onset of surgical site complications, and the absence of mesh are strong risk factors for recurrence.

Published
2020

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