72316 - Trends and Prevalence of Umbilical Hernia Repairs in Sweden; A Nationwide Population-based Register-study

Abstract Introduction Umbilical hernia repairs (UHRs) are widely performed worldwide, yet knowledge about their repairs remains underexplored. Guidelines suggest that UHR larger than 1 cm should preferably be repaired using mesh. The aim was to assess trends and prevalence over time for the use of suture versus mesh following UHR in Sweden. Method This observational population-based register study included prospectively collected data from the nationwide Swedish Perioperative Register (SPOR). Patients 18 years old with a UHR between 2017-2022 in SPOR were eligible. Surgical units were categorized into six healthcare regions. Primary outcome was change in method of repair over time. Secondary outcome was regional variations in method of repairs. Result Out of 10,356 elective primary UHRs; mesh was used in 47.9%, whereas 14.1% of these were repaired laparoscopically. Women were less frequently repaired with mesh (38.8%) compared to men (52.1%). Suture repairs had a lower median age (49 years) and BMI (27.2 kg/m2) compared to mesh repairs (55 years, BMI 29.7 kg/m2). Lower ASA class (1-2) were predominant in suture repairs (53.8%), while higher ASA class (3-4) were predominant in mesh repairs (59.1%). Mesh repairs increased marginally, 46.1% to 49.3% during the study period (p 0.001). Only the South healthcare region had a significant increase from 25.9% to 56.4% for mesh repairs (p 0.001). Discussion Mesh repairs, despite guidelines, have still not significantly influenced UHR practices in Sweden. Mesh was more commonly used for men, obese patients, those of older age and with a greater co-morbidity.