Improved quality of life after combined plastic and general surgical retromuscular mesh repair for abdominal wall hernia with concurrent rectus diastasis: a retrospective cohort study of 59 post-partum woman.
H J M Smelt, I C M Driessen, E Berkvens, H Hawinkels, S W Nienhuijs, J A Wegdam, T S de Vries Reilingh
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引用次数: 0
Abstract
Purpose: To evaluate hernia recurrence, postoperative complications, and patient reported outcomes after combined open ventral hernia repair (OVHR) and rectus diast asis (RD) reconstruction with abdominal wall contour correction in postpartum women.
Methods: This retrospective study included women (BMI < 30 kg/m2) with symptomatic ventral hernia ≥ 1 cm and concomitant RD ≥ 3 cm who underwent elective combined repair between 2018 and 2024. All patients had completed childbearing, experienced functional complaints, and maximized physiotherapy benefit. Primary outcomes were hernia recurrence and postoperative complications, classified as surgical site occurrences (SSO) and SSO requiring procedural intervention. Secondary outcomes included functional, physical, and cosmetic patient-reported outcomes.
Results: Fifty-nine patients were included. Wound-related complications occurred in 38.9%, mainly wound dehiscence (18.6%) and umbilical necrosis (13.6%). Wound infection occurred in 5.1%, with 3.4% requiring radiologic drainage and 1.7% reoperation. Significant postoperative improvements were observed in abdominal pain (93.2% to 15.3%, p < 0.001), back pain (64.4% to 3.4%, p < 0.001) abdominal swelling (59.3% to 5.1%, p < 0.001), abdominal wall dysfunction (100% to 8.5%, p < 0.001), and physical limitations (61.0% to 0%, p < 0.001). Dissatisfaction with abdominal aesthetics decreased from 100% preoperatively to 18.6% postoperatively (p < 0.001). No hernia recurrence occured.
Conclusion: Combined OVHR and RD reconstruction in postpartum women results in substantial improvements in pain, function, and abdominal wall aesthetics without hernia recurrence. Despite notable wound-related complications, outcomes support the functional and quality-of-life benefits of a multidisciplinary surgical approach. Prospective studies are needed to confirm these findings and optimize perioperative strategies.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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