Preoperative risk factors in hernia recurrence: a single-center study

Background and Objectives. Hernia recurrence is still a great challenge for surgeons regarding the optimal surgical technique, the best alloplastic material and the management of risk factors (advanced age, female sex, body mass index, smoking, diabetes, the presence of connective tissue disorders,...

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Main Authors: Anca Tigora, Vlad Paic, Dragos Nicolae Garofil, Mircea Nicolae Bratucu, Mihai Zurzu, Daniela Nuta, Florian Popa, Valeriu Surlin, Stefan Patrascu, Victor Strambu, Petru Adrian Radu
Format: Article
Language:English
Published: MDPI AG 2024-04-01
Series:Journal of Mind and Medical Sciences
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Online Access:https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1487&context=jmms
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author Anca Tigora
Vlad Paic
Dragos Nicolae Garofil
Mircea Nicolae Bratucu
Mihai Zurzu
Daniela Nuta
Florian Popa
Valeriu Surlin
Stefan Patrascu
Victor Strambu
Petru Adrian Radu
author_facet Anca Tigora
Vlad Paic
Dragos Nicolae Garofil
Mircea Nicolae Bratucu
Mihai Zurzu
Daniela Nuta
Florian Popa
Valeriu Surlin
Stefan Patrascu
Victor Strambu
Petru Adrian Radu
author_sort Anca Tigora
collection DOAJ
description Background and Objectives. Hernia recurrence is still a great challenge for surgeons regarding the optimal surgical technique, the best alloplastic material and the management of risk factors (advanced age, female sex, body mass index, smoking, diabetes, the presence of connective tissue disorders, chronic cough, etc.). The present study attempts to assess the impact of these factors in hernia recurrence, as well as the integration of the prosthetic material at the tissue level, in order to reduce possible postoperative complications. Material and Methods. A retrospective study was performed on 108 patients operated (between January 2012 and December 2022) for recurrence of inguinal, umbilical and incisional hernias. Demographic data and comorbidities were analyzed in relation to hernia recurrence. Fragments of unintegrated and well-fitted mesh were sampled and examined microscopically to assess tissue-level implications. Results. The strongest factors associated with hernia recurrence were obesity (p=0.001), diabetes mellitus (p=0.003), high blood pressure (p=0.003) and atrial fibrillation (p=0.044). Microscopic analysis of unintegrated mesh fragments revealed the presence of foreign body granulomas and predominance of thin fibrillar type 3 collagen, whereas well-integrated material showed thick type I collagen fibers and low inflammatory infiltrate. Conclusions. Insufficient oxygen supply, an altered inflammatory response, and diminished proliferative capacity during the wound healing stages resulted in abnormalities in the development of mature granulation tissue. Therefore, to reduce the risk of hernia recurrence, it is essential to have a surgical treatment that must manage all these possible factors.
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spelling doaj-art-3f0d16444e65488a88784ea7bb7bc8a22025-08-20T02:16:33ZengMDPI AGJournal of Mind and Medical Sciences2392-76742024-04-0111114615510.22543/2392-7674.1487Preoperative risk factors in hernia recurrence: a single-center studyAnca Tigora0Vlad Paic1Dragos Nicolae Garofil2Mircea Nicolae Bratucu3Mihai Zurzu4Daniela Nuta5Florian Popa6Valeriu Surlin7Stefan Patrascu8Victor Strambu9Petru Adrian Radu10Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Midwifery and Nursing, Department of Hygiene and Nutrition, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaCraiova University of Medicine and Pharmacy, Sixth Department of Surgery, Craiova Emergency Clinical Hospital, Craiova, RomaniaCraiova University of Medicine and Pharmacy, Sixth Department of Surgery, Craiova Emergency Clinical Hospital, Craiova, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, Tenth Department of Surgery, Bucharest, RomaniaBackground and Objectives. Hernia recurrence is still a great challenge for surgeons regarding the optimal surgical technique, the best alloplastic material and the management of risk factors (advanced age, female sex, body mass index, smoking, diabetes, the presence of connective tissue disorders, chronic cough, etc.). The present study attempts to assess the impact of these factors in hernia recurrence, as well as the integration of the prosthetic material at the tissue level, in order to reduce possible postoperative complications. Material and Methods. A retrospective study was performed on 108 patients operated (between January 2012 and December 2022) for recurrence of inguinal, umbilical and incisional hernias. Demographic data and comorbidities were analyzed in relation to hernia recurrence. Fragments of unintegrated and well-fitted mesh were sampled and examined microscopically to assess tissue-level implications. Results. The strongest factors associated with hernia recurrence were obesity (p=0.001), diabetes mellitus (p=0.003), high blood pressure (p=0.003) and atrial fibrillation (p=0.044). Microscopic analysis of unintegrated mesh fragments revealed the presence of foreign body granulomas and predominance of thin fibrillar type 3 collagen, whereas well-integrated material showed thick type I collagen fibers and low inflammatory infiltrate. Conclusions. Insufficient oxygen supply, an altered inflammatory response, and diminished proliferative capacity during the wound healing stages resulted in abnormalities in the development of mature granulation tissue. Therefore, to reduce the risk of hernia recurrence, it is essential to have a surgical treatment that must manage all these possible factors.https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1487&context=jmmshernia recurrencepreoperative risk factorstype 3-collagentype 1-collagena single-center study
spellingShingle Anca Tigora
Vlad Paic
Dragos Nicolae Garofil
Mircea Nicolae Bratucu
Mihai Zurzu
Daniela Nuta
Florian Popa
Valeriu Surlin
Stefan Patrascu
Victor Strambu
Petru Adrian Radu
Preoperative risk factors in hernia recurrence: a single-center study
Journal of Mind and Medical Sciences
hernia recurrence
preoperative risk factors
type 3-collagen
type 1-collagen
a single-center study
title Preoperative risk factors in hernia recurrence: a single-center study
title_full Preoperative risk factors in hernia recurrence: a single-center study
title_fullStr Preoperative risk factors in hernia recurrence: a single-center study
title_full_unstemmed Preoperative risk factors in hernia recurrence: a single-center study
title_short Preoperative risk factors in hernia recurrence: a single-center study
title_sort preoperative risk factors in hernia recurrence a single center study
topic hernia recurrence
preoperative risk factors
type 3-collagen
type 1-collagen
a single-center study
url https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1487&context=jmms
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