Spanish Registry of Incisional Hernias (EVEREG)
J.A. Pereira
Moderator(s): Dick van Geldere (Zwolle, The Netherlands) & Filip Muysoms (Ghent, Belgium)
16:33 - 16:45h
at Jurriaanse Zaal
Categories: Session 4. Class of 2013
Parallel session: Session 4. Class of 2013
Background:
The Spanish Register of Incisional Hernia starts in July 2012 in Catalonia, since then a total of 109 hospitals of Spain have joined it. At the present day a total of 3308 cases have been included. We present the results of patients registered during the period between January and June 2013.
Methods:
We have designed a website based register for all those patients operated on incisional hernia. The Spanish Register includes anonymous demographic data, incisional hernia characteristics, type of surgical treatment, postoperative results, complications and short and long-termfollow-up.
Results:
During the study period a total of 1000 patients were includedto the database. This is a cohort in which predominates female sex (55.7%), with a median age of 63.0 years (13.5), median BMI of 30.2 (5.6), and ASA II was the most frequent score.
Sixty-five patients (6.5%) were operated for an acute hernia complication. Laparoscopy was used in 116 patients (11.6%). 197 patients (19.7%) were operated due to a recurrence of previous repair; many of them have a previous mesh repair (69%).
The most frequent location of the hernia was a midline laparotomy (66.2%) followed by trocar hernia (15.1%).
Mesh repair was the rule, although a small number of patients didn’t receiveprosthesis. The most common type of mesh was polypropylene (70,5%). The most frequent position of the mesh in open surgery was “onlay” (61%) and components separation was associated in 164 patients (16,4%).
Postoperative complications were frequent (32.2%); the most of them were minor complications (seroma, wound infection and haematoma). Mortality of the series was 0.9%, in emergency cases it increases to 3.5%.
395 patients (39.5%) have available data of follow-up during a median time of 6.6 months. 28 recurrences have been diagnosed (7.2%), but if we only consider patients followed more than six months (154) the percentage of recurrences increases to a 16.2%. 37 patients (9.5%) presented chronic pain, and 7.2% chronic wound infection. Only one patient needed a mesh removal.
Conclusion:
In Spain the most common type of repair in incisional hernia is onlay technique with polypropylene mesh; laparoscopic approach is performed only in 11.6% of cases. Morbidity rate is high but most often related to minor complications. Recurrence rate is high in patients with long-term follow-up. With these results, we need to develop improvement strategies in our practice. Data analysis must be cautiously interpreted because a large number of patients have not had enough follow-up. We should improve thoroughness and reliability of our data.
