The risk factors of seromas and long-term results after umbilical hernia with diastasis recti repair (SCOLA)

Abstract

Objective The purpose of this study was to assess results in umbilical hernia with diastasis recti repair, risk factors for seromas and to identify long-term follow-up results of a “new” technique (SCOLA). Methods A prospective Cohort study of the patients who underwent elective surgery for small (< 2 cm) and medium (2-4 cm) size of primary umbilical hernia with diastasis recti. The patient’s follow-up period was 12 months. Hernia reccurence and seromas diagnosis was based on the patient’s physical examination and paraumbilical area ultrasound, performed by radiologist. Postoperative pain was evaluated using Visual Analogue Scale (VAS). To evaluate quality of life we used the Carolinas Comfort Scale (CCS) questionnaire. Results One hundred patients underwent elective surgery for umbilical hernia with diastasis recti over the period of 2 years. The mean patients age was 36.6 years (range 22-77 years). Most of the patients were females (n=77, 77%). The median operating time was 120 minutes. Thirty two patients (32%) were operated with mesh repair and 68 (68%) patients without mesh. Only one patient had postoperative complication (wound hematoma) during hospital stay. Median hospital stay was 2 days. There was no hernia or diastasis reccurence during follow-up period. The seroma was found in 15 (15%) cases during first follow-up month. There were 11 (11%) cases of seroma after third month and after 6 months were only 2 (2%) cases of seroma. Almost half of patients (63%) had abdominal skin hypostesia after 6 months. Almost all the patients after surgery had mild or moderate symptoms at the daily activity. Conclusions SCOLA is a safe and effective technique for the patients with umbilical hernia and diastasis recti. This technique gives an acceptable cosmetic result to patients, low postoperative pain and short hospital stay, and good quality of life. Brief description of the abstract Diastasis recti is a very common condition with functional and cosmetic effects that can occur in female and male patients, with a 30-70% prevalence and can be associated with umbilical or epigastric hernias. In recent years, a endoscopic subcutaneous onlay approach (SCOLA, REPA, ELAR etc.) mesh repair in combination with anterior plication of diastasis have recently become a common procedure.