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The Effect of Sutures Versus Mesh in Umbilical Hernia Repair (ABSNOME)

This study has been completed.
Information provided by (Responsible Party):
Mette Willaume Christoffersen, Hvidovre University Hospital Identifier:
First received: July 4, 2012
Last updated: February 19, 2014
Last verified: February 2014

Background Mesh repair reduces the risk of reoperation for recurrence in patients with small umbilical and epigastric hernias compared with sutured repair. However, reoperation for recurrence underestimates total recurrence (reoperation or clinical) and mesh reinforcement may induce chronic pain. This study investigated the cumulated risk of recurrence after open mesh and sutured repair in small (≤2 cm) umbilical and epigastric hernias. Possible risk factors were evaluated for chronic pain and recurrence.

Methods A cohort study with questionnaire-follow-up was conducted. Patients with primary, elective, open mesh or sutured repair for a small umbilical or epigastric hernia (≤2 cm) were included. Follow-up was performed by a validated questionnaire regarding suspicion of recurrence and chronic pain (moderate or severe). Suspected recurrence qualified for clinical examination. Recurrence was defined as reoperation for recurrence or clinical recurrence. Risk factors for recurrence and chronic pain were investigated by multivariate analyses.


1 313 patients completed the questionnaire and/or clinical follow-up (83 % response rate) and follow-up time was median 40 months (range 0-66 months). The total cumulated recurrence rate 55 months after primary repair was 10 % for mesh repair and 21 % for sutured repair (P=0.001). The incidence of chronic pain was 6 % after mesh repair and 5 % after sutured repair (P = 0.711). Recurrence was the only independent risk factor for chronic pain (P<0.001).

Conclusion Mesh repair halved the long-term risk of recurrence after repair for small umbilical and epigastric hernias without increased risk of chronic pain.

Ventral Hernia Midline

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Long Term Recurrence and Chronic Pain After Repair for Small Umbilical or Epigastric Hernias. A Regional Cohort Study.

Resource links provided by NLM:

Further study details as provided by Mette Willaume Christoffersen, Hvidovre University Hospital:

Primary Outcome Measures:
  • recurrence (clinical or reoperation for recurrence) [ Time Frame: 3 years ]
    follow-up time will be from 3-5 years

Secondary Outcome Measures:
  • chronic pain [ Time Frame: 3-5 years after surgery ]
    patient self-registration on VRS. Moderate or severe pain is regarded as chronic pain

Other Outcome Measures:
  • risk factors for recurrence and chronic pain [ Time Frame: 3-5 yrs ]
    We identify risk factor for chronic pain and recurrence

Enrollment: 1313
Study Start Date: December 2012
Study Completion Date: October 2013
Primary Completion Date: October 2013 (Final data collection date for primary outcome measure)
umbilical hernia repair
patients having umbilical or epigastric hernia repair from 2008-2010 in Zealand


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
all patient having mesh or sutured repair of small (> 2 cm) umbilical or epigastric hernias in the region of Zealand from 1th of January 2008 to 31th of December 2010.

Inclusion Criteria:

  • elective open mesh or sutured repair of small umbilical or epigastric hernia repairs

Exclusion Criteria:

  • acute operation
  • operation outside region of Zealand
  • laparoscopic repair
  Contacts and Locations
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Please refer to this study by its identifier: NCT01635868

Hvidovre Hospital University of Copenhagen
Hvidovre, Denmark, 2650
Sponsors and Collaborators
Hvidovre University Hospital
Study Director: Thue Bisgaard, DMSc University Hospital of Copenhagen Hvidovre
  More Information

Responsible Party: Mette Willaume Christoffersen, MD, Hvidovre University Hospital Identifier: NCT01635868     History of Changes
Other Study ID Numbers: ABSNOME
Study First Received: July 4, 2012
Last Updated: February 19, 2014

Additional relevant MeSH terms:
Hernia, Ventral
Pathological Conditions, Anatomical
Hernia, Abdominal processed this record on May 25, 2017