Long-term recurrence and chronic pain after repair for small umbilical or epigastric hernias: a regional cohort study

Abstract Background Mesh repair reduces the risk of reoperation for recurrence in patients with primary ventral hernias. However, reoperation for recurrence underestimates total recurrence (reoperation + clinical) and mesh reinforcement may induce chronic pain. This study investigated the total recurrence and risk of chronic pain in small primary ventral hernias. Methods A cohort study with questionnaire and clinical follow-up was conducted. Patients with primary, elective, open mesh or sutured repair for a small umbilical or epigastric hernia (≤2 cm) were included. Results One thousand three hundred thirteen patients completed the questionnaire. The total cumulated recurrence rate after primary repair was 10% for mesh repair and 21% for sutured repair ( P = .001). The incidence of chronic pain was 6% after mesh repair and 5% after sutured repair ( P = .711). Conclusions Mesh repair halved long-term risk of recurrence after repair for small ventral hernias without increased risk of chronic pain.