Background: Recurrence after incisional hernia repair is one of the major problems related with this operation. Our\nobjective is to analyze the influence of abdominal wall surgery expertise in the results of the open elective repair of\nincisional hernia.\nMethods: We have compiled the data of a cohort of patients who received surgery for an incisional hernia from\nJuly 2012 to December 2015 in a University Hospital. Data were collected prospectively and registered in the\nSpanish Register of Incisional Hernia (EVEREG). The short- and long-term complications between the groups of\npatients operated on by the Abdominal Wall Surgery (AWS) unit and groups operated on by surgeons outside of\nthe specialized abdominal wall group (GS) were compared.\nResults: During the study period, a total of 237 patients were operated on by the open approach (114 AWS; 123\nGS). One hundred seventy-five patients completed a median follow-up of 36.6 months [standard deviation (SD) = 6].\nGroups were comparable in terms of age, sex, body mass index (BMI), comorbidities, and complexity of hernia.\nComplications were similar in both groups. Patients in the AWS group presented fewer recurrences (12.0% vs.\n28.9%; P = 0.005). The cumulative incidence of recurrence was higher in the GS group [log rank 13.370; P < 0.001;\nodds ratio (OR) = 37.8; 95% confidence interval (CI) = 30.3-45.4]. In the multivariate analysis, surgery performed by\nthe AWS unit was related to fewer recurrences (OR = 0.19; 95%CI = 0.07-0.58; P < 0.001).\nConclusion: Incisional hernia surgery is associated with better results in terms of recurrence when it is performed\nin a specialized abdominal wall unit.
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