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Current practice patterns for initial umbilical hernia repair in the United States.

Publication ,  Journal Article
Koebe, S; Greenberg, J; Huang, L-C; Phillips, S; Lidor, A; Funk, L; Shada, A
Published in: Hernia
June 2021

PURPOSE: The approach to repairing an initial umbilical hernia (IUH) varies substantially, and this likely depends on hernia size, patient age, sex, BMI, comorbidities including diabetes mellitus, and surgeon preference. Of these, only hernia size has been widely studied. This cross-sectional study aims to look at the practice pattern of umbilical hernia repair in the United States. METHODS: A retrospective study was performed using data from the America Hernia Society Quality Collaborative. Patient characteristics included age, sex, hernia width, BMI, smoking status, and diabetes. Outcomes were use of mesh for repair, as well as surgical approach (open vs minimally invasive). Multivariate logistic regression was performed to assess the independent effect of age, sex, hernia width, BMI, smoking status, and diabetes on use of mesh and approach to repair. RESULTS: 3475 patients were included. 74% were men. Mesh use was more common in men (67% vs 60%, P < 0.001). Mesh was used in 33% of repairs ≤ 1 cm, and 82% of repairs > 1 cm (P < 0.001). Younger patients were less likely to receive a mesh repair (54% if age ≤ 35 vs 67% for age > 35, P < 0.001). However, on multivariate analysis, mesh use was associated with increasing hernia width (OR 5.474, 95% CI 4.7-6.3) as well as BMI (OR 1.8, 95% CI 1.5-2.1) but not with age or sex. CONCLUSION: The majority of IUH are performed open. Patient BMI and hernia defect size contribute to choice of surgical technique including use of mesh. The use of mesh in 33% of hernias below 1 cm demonstrates a gap between evidence and practice. Patient factors including patient age and sex had no impact on operative approach or use of mesh.

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Published In

Hernia

DOI

EISSN

1248-9204

Publication Date

June 2021

Volume

25

Issue

3

Start / End Page

563 / 570

Location

France

Related Subject Headings

  • United States
  • Surgical Mesh
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Male
  • Laparoscopy
  • Humans
  • Herniorrhaphy
  • Hernia, Ventral
 

Citation

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ICMJE
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Koebe, S., Greenberg, J., Huang, L.-C., Phillips, S., Lidor, A., Funk, L., & Shada, A. (2021). Current practice patterns for initial umbilical hernia repair in the United States. Hernia, 25(3), 563–570. https://doi.org/10.1007/s10029-020-02164-z
Koebe, S., J. Greenberg, L. -. C. Huang, S. Phillips, A. Lidor, L. Funk, and A. Shada. “Current practice patterns for initial umbilical hernia repair in the United States.Hernia 25, no. 3 (June 2021): 563–70. https://doi.org/10.1007/s10029-020-02164-z.
Koebe S, Greenberg J, Huang L-C, Phillips S, Lidor A, Funk L, et al. Current practice patterns for initial umbilical hernia repair in the United States. Hernia. 2021 Jun;25(3):563–70.
Koebe, S., et al. “Current practice patterns for initial umbilical hernia repair in the United States.Hernia, vol. 25, no. 3, June 2021, pp. 563–70. Pubmed, doi:10.1007/s10029-020-02164-z.
Koebe S, Greenberg J, Huang L-C, Phillips S, Lidor A, Funk L, Shada A. Current practice patterns for initial umbilical hernia repair in the United States. Hernia. 2021 Jun;25(3):563–570.
Journal cover image

Published In

Hernia

DOI

EISSN

1248-9204

Publication Date

June 2021

Volume

25

Issue

3

Start / End Page

563 / 570

Location

France

Related Subject Headings

  • United States
  • Surgical Mesh
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Male
  • Laparoscopy
  • Humans
  • Herniorrhaphy
  • Hernia, Ventral