Abstract
Ventral hernia repair is a common surgical procedure, but the postoperative follow-up remains a critical concern. While many surgeons consider short-term follow-up sufficient, the literature suggests that longer follow-up is necessary. Socioeconomic factors and comorbidities may influence the postoperative follow-up. We aimed to analyze the differences in patient and hernia profiles among different postoperative follow-up periods, and analyze factors influencing the absence of postoperative follow-up.
Patients with VHR were divided based on postoperative follow-up. We analyzed the impact of baseline characteristics, comorbidities, hernia, and surgical details, and postoperative complications on the postoperative follow-up. A multivariate regression analysis was performed to identify the absence of follow-up. Statistical analyses were conducted using R software.
A total of 391 patients were included: 42 (10.7%) had no follow-up (FU), 284 (72.6%) had FU < 6 months, 31 (7.9%) between 6 and 12 months, and 34 (8.7%) > 1 year. White patients were more frequent in longer FU groups (p = 0.02). No FU was more common in cirrhotic patients (p = 0.02) and those with umbilical hernias (p = 0.04). Epigastric and recurrent hernias, symptomatic cases, longer operative time, hospital stay, drain use, and higher postoperative pain scores were associated with longer FU (p < 0.05). In multivariate analysis, no-white race was associated with higher odds of no FU (OR = 3.03, p = 0.01), while higher pain levels (OR = 0.12, p = 0.004) and a longer hospital stay reduced the odds of no FU, with each additional day of hospitalization decreasing the odds of presenting no follow-up (OR = 0.16, p < 0.001).
Our findings indicate that patients with multiple comorbidities and more complex and symptomatic hernias tend to have longer follow-up periods. A racial disparity was also identified, with non-white patients being followed up less frequently than white patients. Higher recurrence rates in longer follow-up groups highlight the necessity to track patients for a longer follow-up period.
PHXU-22-500-241-73-21, 03/26/2022.