Long-term outcomes of primary ventral hernia repair associated with rectus diastasis

Primary ventral hernia repair is a common global surgical procedure, entailing economic burdens and recurrence challenges. Rectus diastasis (RD) is considered a risk factor for midline defects, and treatment is symptom-based. When primary ventral hernia and RD coexist, management s*ll remains unclear. This study aims to analyze recurrence rates in pa*ents aEer umbilical/epigastric hernia repair with untreated diastasis. Methods. Observa*onal and retrospec*ve cohort study of 74 pa*ents assessing the recurrence rate of umbilical or epigastric hernias in pa*ents operated with or without RD. Data were obtained from a ter*ary hospital's pa*ents between 2015 and 2017. Medium-term recurrences were analyzed aEer at least 3-year follow up. We compared demographic data, presence of RD (defined as rectus muscles separa*on exceeding 2 cm), type of repair and surgical complica*ons. Results. Data on 74 pa*ents were collected. The mean age was 57.08 years, and the mean BMI was 31.27 Kg/m2. Thirty-one included pa*ents were females (42.9%). RD was documented in 67.1% of the sample. Mean follow-up was 4.23 (+/- 2.53) years. Postopera*ve complica*ons were predominantly grade 1 according to the Clavien-Dindo classifica*on, with a 17.14% surgical site infec*on rate. Female gender (p=0.039), diabetes (0.016), and RD (0.049) showed sta*s*cally significant differences in predic*ng the risk of medium-term recurrence. Conclusion. Pa*ents with untreated RD face a higher risk of medium-term recurrence following primary ventral hernia repair. Addi*onally, female gender and diabetes were found to be independent risk factors. Prospec*ve studies are recommended to further assist surgeons in choosing the op*mal surgical strategy for pa*ents with umbilical hernia and associated RD