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Khashayar Mohebali, MD; David M. Young, MD; Scott L. Hansen, MD; Alexandra Shawo, BS; Christopher E. Freise, MD; David S. Chang, MD; John Maa, MD; Hobart W. Harris, MD, MPH

Arch Surg. 2009;144(9):848-852.

Objective  To describe the postoperative complication rates of a large consecutive series of patients who underwent open incisional ventral hernia repair.

Design  Retrospective medical record review of an accumulated database.

Setting  University tertiary care medical center.

Patients  All patients who underwent open incisional ventral hernia repair from March 1, 2003, through February 28, 2008.

Intervention  Open incisional ventral hernia repair.

Main Outcome Measures  Postoperative complications, including hernia recurrences.

Results  A total of 507 cases (465 patients; female to male ratio, 1.1:1) met our criteria; median follow-up was 40 months. In 23.5% of the cases, repair had been attempted previously, and 16.4% had previously undergone organ transplant. The postoperative complication rate was 38.1%. Hernias recurred in 18.9% of cases. Perioperative mortality was 1.0%. Patients undergoing transplant were more likely than those not undergoing transplant to have a hernia recurrence (16.3% vs 32.5%; P < .001) and were equally likely to have a postoperative complication (36.9% vs 44.6%; P = .19). Patients who underwent repair of a recurrent incisional hernia were as likely to have a hernia recurrence as those who underwent initial repair (21.0% vs 18.3%; P = .52) but more likely to have an overall complication (47.9% vs 35.1%; P = .01).

Conclusions  In this series of incisional hernia repairs at a tertiary care center, the overall recurrence rate of 18.9% is comparable to that of other published series. Ours is the largest published series of recurrent hernias that shows a recurrence rate comparable to that for initial repairs. This outcome may be the result of greater use of more complex repair techniques.

Author Affiliations: Divisions of Plastic & Reconstructive Surgery (Drs Mohebali, Young, and Hansen), General Surgery (Ms Shawo and Drs Maa and Harris), and Transplant Surgery (Dr Freise), Department of Surgery, University of California, San Francisco.

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