Risk factors for primary anterior abdominal wall hernias and early recurrence: a retrospective study from Jordan

Rama T. Alzu’bi; Ata M. Ghaith; Rama R. Raddad

doi:10.18203/2349-2902.isj20260452

Authors

Rama T. Alzu’bi Department of General Practitioner, Ministry of health, Amman, Jordan
Ata M. Ghaith Department of Surgery, Al-Balqa Applied University, Al-Salt New Hospital, Al-Salt, Jordan
Rama R. Raddad Department of General Practitioner, Ministry of health, Amman, Jordan

DOI:

https://doi.org/10.18203/2349-2902.isj20260452

Keywords:

Anterior abdominal wall hernia, Hernia recurrence, Risk factors, Mesh repair, Suture repair, Constipation, Smoking, Multivariable analysis

Abstract

Background: Anterior abdominal wall hernias are common worldwide and recurrence remains a significant clinical challenge. This study aimed to identify different risk factors associated with primary hernia occurrence and early recurrence in a tertiary hospital in Jordan.

Methods: A retrospective study was conducted for a total of 341 adult patients treated for anterior abdominal wall hernias within the Surgical Department of Al-Hussain New Salt Hospital between January 2022 and November 2023, using the open surgical approach. Collected variables included age, sex, smoking status, comorbidities, constipation, family history, anaemia, hernia type, and repair technique. Descriptive statistics, chi-square tests, and multivariable logistic regression were used, with p < 0.05 considered statistically significant.

Results: Among 341 cases, 329 (96.5%) patients presented with primary hernias. Most patients were male (78.4%), and the most common age group was 41–60 years. Inguinal hernias were the most frequently encountered (66.9%). In unadjusted analyses, primary hernia characteristics were significantly associated with sex, age group, smoking, and family history (all p<0.05). Of 341 total cases, only 12 patients (3.5%) experienced recurrence, the majority were male (91.7%), and inguinal hernias accounted for most recurrences (83.3%). In multivariable analysis, constipation (aOR 5.99, 95% CI 1.59–22.62) and primary suture repair (aOR 5.20, 95% CI 1.37–19.40) were independently associated with recurrence, while mesh repair was protective (aOR 0.19, 95% CI 0.051–0.73). Sex, smoking status, and family history were not independently associated after adjustment.

Conclusion: In this cohort, inguinal hernias were the most frequent type, and recurrence was uncommon. Constipation and primary suture repair were independently associated with recurrence, while no significant associations were observed with sex, smoking status, or family history. These findings highlight the importance of addressing modifiable risk factors and optimizing surgical technique to reduce hernia recurrence.

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