Long-Term Outcome of 254 Complex Incisional Hernia Repairs Using the Modified Rives-Stoppa Technique

Iqbal, Corey W.; Pham, Tuan H.; Joseph, Anthony; Mai, Jane; Thompson, Geoffrey B.; Sarr, Michael G.
December 2007
World Journal of Surgery;Dec2007, Vol. 31 Issue 12, p2398
Academic Journal
Repair of complex incisional hernias poses a major challenge. The aim of this study was to review the outcomes of the modified Rives-Stoppa repair of complex incisional hernias using a synthetic prosthesis. We reviewed patients undergoing a modified Rives-Stoppa repair of complex incisional hernias from 1990 to 2003. Patients were followed through clinic visits and mailed questionnaires. Follow-up data were complete in all patients (mean 70 months, range 24–177 months), and 87% of patients completed a mailed questionnaire. Primary outcome included mortality, morbidity, and hernia recurrence. Secondary outcome measures were duration of hospital stay, long-term abdominal wall pain, and self-reported patient satisfaction. Altogether, 254 patients underwent a modified Rives-Stoppa repair. Among them, 60% had a significant co-morbidity, and 30% had one or more previously failed hernia repairs. Mortality was zero, and overall morbidity was 13% (wound infection 4%, prosthetic infection 3%, seroma/hematoma 4%). The overall hernia recurrence rate was 5%, including explantation of mesh because of infection. Wound/prosthetic infection was predictive for hernia recurrence (31% vs. 4%, p = 0.003). Among the respondents, 89% reported overall satisfaction with their repair. The Rives-Stoppa repair of complex incisional hernias using synthetic prosthetic materials is safe with a low recurrence rate (5%) and high patient satisfaction. Postoperative wound infection is a risk factor for hernia recurrence.


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