ORIGINAL ARTICLE Chronic complaints after simple sutured repair for umbilical or epigastric hernias may be related to recurrence Mikkel Westen & Mette W. Christoffersen & Lars N. Jorgensen & Trine Stigaard & Thue Bisgaard Received: 12 April 2013 /Accepted: 6 September 2013 /Published online: 14 September 2013 # Springer-Verlag Berlin Heidelberg 2013 Abstract Purpose Umbilical and epigastric hernia repairs are minor, but are commonly conducted surgical procedures. Long-term results have only been sparsely investigated. Our objective was to investigate the risk of chronic com- plaints after a simple sutured repair for small umbilical and epigastric hernias. Methods A retrospective cohort study with a 5-year question- naire and clinical follow-up was conducted. Patients undergo- ing primary elective, open non-mesh umbilical or epigastric sutured hernia repair were included. Patients completed a structured questionnaire regarding chronic complaints during work and leisure activities using a verbal rating scale. The primary outcome was chronic complaints. Results A total of 295 patients were included for analysis after a median of 5.0-year (range 2.8–8.0) follow-up period. Follow- up results were achieved from 262 of the included patients (90 % response rate). Up till 5.8 % of the patients reported moderate or severe pain and discomfort. Work and leisure activities were restricted in 8.5 and 10.0 % of patients, respectively. Patients with chronic complaints had a higher incidence of recurrence (clinical and reoperation), than patients with none or mild complaints (78.6 vs. 22.2 % (P <0.001)). The recurrence rate was significantly higher after a repair with absorbable suture (20.1 %) compared with non-absorbable suture repair (4.2 %) (P <0.001). Conclusion We found that chronic complaints after a simple sutured umbilical or epigastric repair was in the level of 5.5 % and could in part be explained by recurrence. Furthermore, absorbable suture should be omitted to reduce risk of recurrence. Keywords Umbilical hernia . Sutured repair . Chronic pain . Recurrence . Long-term follow-up Introduction Umbilical and epigastric hernia repairs are minor general surgical procedures [1]. However, there is no consensus on the optimal repair technique [2]. Recurrence rates after mesh repairs are significantly lower than after sutured repair [3–5], but sutured repair is still the most frequently used technique for repair of smaller umbilical and epigastric hernia defects [2]. Only few retrospective and heterogenic studies using a mixture of mesh and sutured repairs have investigated chronic complaints after umbilical and epigastric hernia repairs [6–8]. Our primary objective was to study the risk of chronic complaints after simple sutured repair for umbilical and epi- gastric hernias and the influence of recurrence (clinical recur- rence and operation for recurrence) on chronic complaints. Material and methods Patients This was a retrospective cohort study with a questionnaire follow-up enrolling consecutive patients from two university hospitals with free referral. Patients were identified by national The study was approved by the Danish Data Protection Agency (reg. no. 2008-58-0020) and the Ethics Committee of the Capital Region (reg.no.: KF07329141), and registered by clinicaltrials.gov (ID: NCT0174740). M. Westen : M. W. Christoffersen : T. Bisgaard Gastrounit, Surgical Divison, Hvidovre University Hospital, Kettegård Alle 30, 2650 Hvidovre, Denmark L. N. Jorgensen Department of Surgery, Bispebjerg University Hospital, Copenhagen, Nordvest, Denmark T. Stigaard Department of Surgery, Køge Hospital, Køge, Denmark M. W. Christoffersen (*) Kettegård Alle 30, 2650 Hvidovre, Denmark e-mail: mette.willaume@gmail.com Langenbecks Arch Surg (2014) 399:65–69 DOI 10.1007/s00423-013-1119-9