ArticleHernia : the journal of hernias and abdominal wall surgery2014
Importance of recurrence rating, morphology, hernial gap size, and risk factors in ventral and incisional hernia classification.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Pooled data analysis of primary ventral (PVH) and incisional hernia (IH) repair is no more acceptable: results of a systematic review and metanalysis of current literature.Hernia : the journal of hernias and abdominal wall surgery · 2019Pooled it
- A systematic methodological review of reported perioperative variables, postoperative outcomes and hernia recurrence from randomised controlled trials of elective ventral hernia repair: clear definitions and standardised datasets are needed.Hernia : the journal of hernias and abdominal wall surgery · 2018Pooled it
- European Hernia Society guidelines on prevention and treatment of parastomal hernias.Hernia : the journal of hernias and abdominal wall surgery · 2018Guideline
- The Treatment of Incisional Hernia.Deutsches Arzteblatt international · 2018Pooled it
- Lessons and challenges during a 5-year follow-up of 21 Composix Kugel implantations.Hernia : the journal of hernias and abdominal wall surgery · 2013Trial
- Risk factors of incisional hernia enlargement after colorectal cancer surgery: a retrospective, single-center study.Surgery today · 2026Article
- Standardization of laparoscopic intraperitoneal onlay mesh repair for incisional hernia: Impact on clinical outcome and quality-of-life (LIPOM trial, NCT 02089958).Contemporary clinical trials communications · 2025Article
- Effectiveness of pre-operative chemical component separation with computed tomography-guided intramuscular injection of OnabotulinumtoxinA in outcomes of large complex incisional ventral abdominal hernia repair: a propensity score-weighted comparative analysis.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Concurrent minimally invasive bariatric surgery and ventral hernia repair with mesh; Is it safe? Propensity score matching analysis using the 2015-2022 MBSAQIP database.Surgical endoscopy · 2024Article
- Does smoking influence the clinical outcomes of robotic ventral hernia repair? A propensity score matching analysis study.Journal of robotic surgery · 2023Article
- Advantages of laparoscopic hepatic hemangioma surgery in quality of life: a prospective study.Surgical endoscopy · 2022Article
- Article
- Hernia width explains differences in outcomes between primary and incisional hernias: a prospective cohort study of 9159 patients.Hernia : the journal of hernias and abdominal wall surgery · 2021Article
- Exploration of Surgeon Motivations in Management of Abdominal Wall Hernias: A Qualitative Study.JAMA network open · 2020Article
- Quality of Life after Complex Abdominal Wall Reconstruction.Visceral medicine · 2020Article
- Short-term comparison between preperitoneal and intraperitoneal onlay mesh placement in robotic ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2019Article
- Predictors of hernia recurrence after Rives-Stoppa repair in the treatment of incisional hernias: a retrospective cohort.Surgical endoscopy · 2019Article
- Risk Factors for Incisional Hernia in Children.World journal of surgery · 2018Article
- Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study.Langenbeck's archives of surgery · 2018Article
- Incidence of Clinically Relevant Incisional Hernia After Colon Cancer Surgery and Its Risk Factors: A Nationwide Claims Study.World journal of surgery · 2018Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is limited evidence on the natural course of ventral and incisional hernias and the results of hernia repair, what might partially be explained by the lack of an accepted classification system. The aim of the present study is to investigate the association of the criteria included in the Wuerzburg classification system of ventral and incisional hernias with postoperative complications and long-term recurrence.
methodsIn a retrospective cohort study, the data on 330 consecutive patients who underwent surgery to repair ventral and incisional hernias were analyzed. The following four classification criteria were applied: (a) recurrence rating (ventral, incisional or incisional recurrent); (b) morphology (location); (c) size of the hernial gap; and (d) risk factors. The primary endpoint was the occurrence of a recurrence during follow-up. Secondary endpoints were incidence of postoperative complications. Independent association between classification criteria, type of surgical procedures and postoperative complications was calculated by multivariate logistic regression analysis and between classification criteria, type of surgical procedures and risk of long-term recurrence by Cox regression analysis.
resultsFollow-up lasted a mean 47.7 ± 23.53 months (median 45 months) or 3.9 ± 1.96 years. The criterion "recurrence rating" was found as predictive factor for postoperative complications in the multivariate analysis (OR 2.04; 95 % CI 1.09-3.84; incisional vs. ventral hernia). The criterion "morphology" had influence neither on the incidence of the critical event "recurrence during follow-up" nor on the incidence of postoperative complications. Hernial gap "width" predicted postoperative complications in the multivariate analysis (OR 1.98; 95 % CI 1.19-3.29; ≤5 vs. >5 cm). Length of the hernial gap was found to be an independent prognostic factor for the critical event "recurrence during follow-up" (HR 2.05; 95 % CI 1.25-3.37; ≤5 vs. >5 cm). The presence of 3 or more risk factors was a consistent predictor for "recurrence during follow-up" (HR 2.25; 95 % CI 1.28-9.92). Mesh repair was an independent protective factor for "recurrence during follow-up" compared to suture (HR 0.53; 95 % CI 0.32-0.86).
conclusionsThe ventral and incisional hernia classification of Dietz et al. employs a clinically proven terminology and has an open classification structure. Hernial gap size and the number of risk factors are independent predictors for "recurrence during follow-up", whereas recurrence rating and hernial gap size correlated significantly with the incidence of postoperative complications. We propose the application of these criteria for future clinical research, as larger patient numbers will be needed to refine the results.
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