Authors: D Kokotovic H Sjølander I Gögenur F Helgstrand
Publish Date: 2016/02/02
Volume: 20, Issue: 2, Pages: 281-287
Abstract
Due to risks of postoperative morbidity and recurrence some patients with a ventral hernia are not offered surgical repair There is limited data on the rate and consequences of a watchful waiting WW strategy for these patients The objective of this cohort study was to analyse outcomes for patients with a ventral hernia who underwent watchful waiting in terms of later requirement for hernia repairAll patients ≥18 years electively referred to our outpatient clinic from 1 January 2009 to 1 July 2014 with incisional umbilical or epigastric hernia were included Information on patient characteristics and whether patients underwent WW or surgery was obtained from hospital files and the Danish National Patient Register A 100 followup was obtainedThe analyses comprised 569 patients with incisional hernia WW = 581 and 789 patients with umbilical/epigastric hernia WW = 432 Kaplan–Meier analyses estimated that the probability for patients who underwent watchful waiting to receive later surgical repair was 19 for incisional hernias and 16 for umbilical/epigastric hernias after 5 years The probability of requiring emergency repair when in the WW group was 4 for both incisional and umbilical/epigastric hernias after 5 years There were no significant differences in 30day readmission reoperation or mortality rates between the WW patients who later underwent elective hernia repair and patients who were initially offered surgery p 005 for both incisional and umbilical/epigastric herniasThe study was partly funded by a private foundation “Edgar Schnohr and wife Gilberte Schnohr’s foundation” which is established to support independent surgical and anesthesiological research The foundation had no influence on design and conduct of the study nor collection management analysis and interpretation of the data Furthermore the foundation had no influence on preparation review or approval of the manuscript and on the decision to submit the manuscript for publicationThe study was partly funded by a private foundation “Edgar Schnohr and wife Gilberte Schnohr’s foundation” which is established to support independent surgical and anesthesiological research The foundation had no influence on design and conduct of the study nor collection management analysis and interpretation of the data Furthermore the foundation had no influence on preparation review or approval of the manuscript and on the decision to submit the manuscript for publication
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