ArticleHernia : the journal of hernias and abdominal wall surgery2026
Repair of elective epigastric hernias in adults: nationwide registry study of short- and long-term complications requiring reoperation.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06783036 (Long-term Recurrence and Other Complications Requiring Surgery Following Primary Ventral Hernia Repair), which is not on this map. Not yet cited in PubMed.
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Long-term Recurrence and Other Complications Requiring Surgery Following Primary Ventral Hernia Repair
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6 authors.
Funding
Abstract
purposeTo define the role of different mesh positions in elective epigastric hernia repair (EHR) for fascial defects < 10 cm.
methodsA retrospective nationwide Danish cohort of adult patients undergoing EHR from 2017 to 2020, ensuring complete follow-up on December 31, 2023, through nationwide registries and scrutiny of all operative notes of subsequent re-interventions. Primary outcome was reoperation for recurrence. Secondary outcomes were reoperation for non-recurrence and any complications. Multivariable analyses were performed using Cox proportional hazards regression, with Firth's penalized likelihood when applicable.
resultsAmong 1,112 patients included, 69.2% underwent mesh repair. Median follow-up was 4.77 years. Mesh repair had significant lower risk of reoperation for hernia recurrence than suture repair (hazard-ratio (HR) 0.28, p = 0.007). Open preperitoneal, retromuscular, or intraperitoneal (open sublay or open IPOM) and laparoscopic intraperitoneal onlay mesh (lap-IPOM) were independently associated with lower recurrence risk compared with suture repair (p < 0.001 and p = 0.006). Reoperation for non-recurrence complications was more frequent after mesh repair than after suture repair (5.27, p = 0.029). Open onlay and lap-IPOM were associated with a nearly sevenfold increased risk of non-recurrence complications (p = 0.014 and p = 0.033). Few non-recurrence complications were directly mesh-related, and severe complications were rare. Open sublay or open IPOM repair was associated with a reduced risk of reoperation for any complication (0.21, p = 0.039).
conclusionMesh repair was associated with reduced reoperation for hernia recurrence, but increased risk of non-recurrence complications compared with suture repair, resulting in a comparable overall risk of reoperation. Open sublay or open IPOM repair demonstrated the most favorable profile, with reduced recurrence and few overall complications, whereas open onlay and lap-IPOM were associated with increased non-recurrence complications.
trial registrationClinicalTrials.gov ID: NCT06783036.
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