A modified Chevrel technique for ventral hernia repair: long-term results of a single centre cohort

Hernia. 2017 Aug;21(4):591-600. doi: 10.1007/s10029-017-1602-2. Epub 2017 Apr 13.

Abstract

Purpose: To evaluate the short- and long-term results after a modified Chevrel technique for midline incisional hernia repair, regarding surgical technique, hospital stay, wound complications, recurrence rate, and postoperative quality of life. These results will be compared to the literature derived reference values regarding the original and modified Chevrel techniques.

Methods: In this large retrospective, single surgeon, single centre cohort all modified Chevrel hernia repairs between 2000 and 2012 were identified. Results were obtained by reviewing patients' medical charts. Postoperative quality of life was measured using the Carolina Comfort Scale. A multi-database literature search was conducted to compare the results of our series to the literature based reference values.

Results: One hundred and fifty-five patients (84 male, 71 female) were included. Eighty patients (52%) had a large incisional hernia (width ≥ 10 cm) according the definition of the European Hernia Society. Fourteen patients (9%) underwent a concomitant procedure. Median length-of-stay was 5 days. Within 30 days postoperative 36 patients (23.2%) had 39 postoperative complications of which 30 were mild (CDC I-II), and nine severe (CDC III-IV). Thirty-one surgical site occurrences were observed in thirty patients (19.4%) of which the majority were seroma (16 patients 10.3%). There was no hernia-related mortality during follow-up. Recurrence rate was 1.8% after a median follow-up of 52 months (12-128 months). Postoperative quality of life was rated excellent.

Conclusions: The modified Chevrel technique for midline ventral hernias results in a moderate complication rate, low recurrence rate and high rated postoperative quality of life.

Keywords: Anterior fascia turnover technique; Complications; Modified Chevrel technique; Recurrence; Ventral hernia repair.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / adverse effects
  • Herniorrhaphy / methods*
  • Humans
  • Incisional Hernia / surgery*
  • Length of Stay
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Period
  • Quality of Life
  • Recurrence
  • Retrospective Studies
  • Surgical Mesh / adverse effects
  • Wound Healing