Long-term results of incisional hernia repair with retromuscular mesh

Abstract

Background: Post-operative hernia is the most frequent complication following abdominal surgery. Hernia repair used to be done by direct suture of the abdominal wall, but nowadays mesh placement is the method of choice. It has been demonstrated that the retromuscular position of the mesh is most appropriate. The treatment results and the patients’ views of the treatment are presented. Methods: Treatment results were analyzed retrospectively, and the patients who had been operated on for postoperative hernia were interviewed. Results: Between January 2004 and December 2008, 150 patients with postoperative hernia were operated on. The analysis 2 (1.3 %) refused to cooperate, and 5 patients (3.3 %) died. The mean age of the interviewees was 64.4 years and the mean hospital stay was 4.2 days. During hospital stay, 14 patients out of the total of 121 interviewed patients (11.6 %) experienced complications and 6 patients (4.9 %) had a wound infection. During the mean observation period of 36 months, 5 patients (4.1 %) presented with recurrences. The mean duration of postoperative pain was 6.6 weeks; 35 patients (28.9 %) continued taking analgesics at home; 22 patients (18.2 %) still felt pain in the wound during the interview. The mean recovery to normal, daily activities took 8 weeks. Nearly one quarter of the patients (23.9 %) reported still being careful about engaging in daily activities. The majority of the patients, i.e. 116 patients (95.9 %), were satisfied with the surgical procedure and would recommend it to a relative in the same situation. Conclusions: The retromuscular mesh placement for postoperative hernia repair results in a low rate of recurrences and postoperative complications. Complications are more common in patients admitted due to incarceration and in patients having suffered from stoma. Pain inflicted by postoperative hernia repair is an underrated with treatment results.