Open repair of flank and lumbar hernias: 142 consecutive repairs at a high-volume hernia center

Am J Surg. 2024 Apr 10:S0002-9610(24)00231-9. doi: 10.1016/j.amjsurg.2024.04.014. Online ahead of print.

Abstract

Background: Flank and lumbar hernias (FLH) are challenging to repair. This study aimed to establish a reproducible management strategy and analyze elective flank and lumbar repair (FLHR) outcomes from a single institution.

Methods: A prospective analysis using a hernia-specific database was performed examining patients undergoing open FLHR between 2004 and 2021. Variables included patient demographics and operative characteristics.

Results: Of 142 patients, 106 presented with flank hernias, and 36 with lumbar hernias. Patients, primarily ASA Class 2 or 3, exhibited a mean age of 57.0 ​± ​13.4 years and BMI of 30.2 ​± ​5.7 ​kg/m2. Repairs predominantly utilized synthetic mesh in the preperitoneal space (95.1 ​%). After 29.9 ​± ​13.1 months follow-up, wound infections occurred in 8.3 ​%; hernia recurrence was 3.5 ​%. At 6 months postoperatively, 21.2 ​% of patients reported chronic pain with two-thirds of these individuals having preoperative pain.

Conclusions: Open preperitoneal FLHR provides a durable repair with low complication and hernia recurrence rates over 2.5 years of follow-up.

Keywords: Abdominal wall reconstruction; Flank hernia; Hernia; Hernia repair; Lateral abdominal wall hernia; Lumbar hernia.