Predictors for recurrence after open umbilical hernia repair in 979 patients.

BACKGROUND: Our study aims were to evaluate factors that predict recurrence after open umbilical hernia repair with either mesh or primary closure.

METHODS: Consecutive patients (n = 1,125) undergoing open umbilical hernia repair from 2009 to 2018 were identified from a prospectively managed, quality database. Kaplan-Meier curves and log-rank tests were used to analyze recurrence-free survival for preoperative, intraoperative, and postoperative factors. Univariable and multivariable Cox regression was used to analyze recurrence-free survival by age, sex, body mass index, concurrent laparoscopic inguinal hernia repair, smoking status, diabetes, postoperative infection, hernia size in greatest dimension, and type of repair.

RESULTS: The overall recurrence rate was 3.3% with a median follow-up of 14 months. Univariable analysis revealed a difference in recurrence-free survival for current smoking (P = .039), diabetes (P = .007), higher body mass index (P = .057), and postoperative infection (P < .001). Multivariable analysis indicated higher body mass index (P = .007), concurrent laparoscopic inguinal hernia repair (P = .044), current smoking status (P = .020), diabetes (P = .021), and a primary closure repair of hernias ≥1.5 cm (P = .001) had a greater risk of recurrence. Postoperative infection showed an association with recurrence (P = .053).

CONCLUSION: Our results indicate higher body mass index, concurrent laparoscopic inguinal hernia repair, current smoking, diabetes, primary closure repair of hernias ≥1.5 cm, and postoperative infection were associated with a greater risk of recurrence after open umbilical hernia repair.