Original article
Initial Results of the National Registry of Incisional Hernia
Resultados iniciales del Registro Español de Hernia Incisional
José Antonio Pereiraa,b,
, Manuel López-Canoc,d, Pilar Hernández-Granadose, Xavier Feliuf,✠, on behalf of the EVEREG group ◊
Corresponding author
a Servicio de Cirugía General, Hospital Universitari del Mar, Barcelona, Spain
b Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
c Servicio de Cirugía General, Hospital Vall d’Hebrón, Barcelona, Spain
d Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain
e Hospital Universitario Fundación Alcorcón, Madrid, Spain
f Hospital de Igualada, Consorci Sanitari de l’Anoia, Igualada, Barcelona, Spain
Read
3307
Timeswas read the article
642
Total PDF
2665
Total HTML
Share statistics
array:24 [ "pii" => "S2173507716301569" "issn" => "21735077" "doi" => "10.1016/j.cireng.2016.09.014" "estado" => "S300" "fechaPublicacion" => "2016-12-01" "aid" => "1679" "copyright" => "AEC" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Cir Esp. 2016;94:595-602" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 981 "formatos" => array:3 [ "EPUB" => 9 "HTML" => 759 "PDF" => 213 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0009739X16301671" "issn" => "0009739X" "doi" => "10.1016/j.ciresp.2016.09.008" "estado" => "S300" "fechaPublicacion" => "2016-12-01" "aid" => "1679" "copyright" => "AEC" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Cir Esp. 2016;94:595-602" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2081 "formatos" => array:3 [ "EPUB" => 26 "HTML" => 1620 "PDF" => 435 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Resultados iniciales del Registro Español de Hernia Incisional" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "595" "paginaFinal" => "602" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Initial results of the National Registry of Incisional Hernia" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1452 "Ancho" => 1737 "Tamanyo" => 98482 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Tipo de prótesis usada.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Antonio Pereira, Manuel López-Cano, Pilar Hernández-Granados, Xavier Feliu" "autores" => array:5 [ 0 => array:2 [ "nombre" => "José Antonio" "apellidos" => "Pereira" ] 1 => array:2 [ "nombre" => "Manuel" "apellidos" => "López-Cano" ] 2 => array:2 [ "nombre" => "Pilar" "apellidos" => "Hernández-Granados" ] 3 => array:2 [ "nombre" => "Xavier" "apellidos" => "Feliu" ] 4 => array:1 [ "colaborador" => "en representación del grupo EVEREG" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173507716301569" "doi" => "10.1016/j.cireng.2016.09.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507716301569?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X16301671?idApp=UINPBA00004N" "url" => "/0009739X/0000009400000010/v1_201612030117/S0009739X16301671/v1_201612030117/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173507716301417" "issn" => "21735077" "doi" => "10.1016/j.cireng.2016.11.009" "estado" => "S300" "fechaPublicacion" => "2016-12-01" "aid" => "1582" "copyright" => "AEC" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Cir Esp. 2016;94:603" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 491 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 372 "PDF" => 109 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "Ruptured Giant Hepatic Artery Aneurysm" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "603" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Rotura de un aneurisma gigante de arteria hepática" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1487 "Ancho" => 2500 "Tamanyo" => 363871 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mario González Gay, Amer Zanabili Al-Sibbai, Livia Revuelta Mariño, Manuel Alonso Pérez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Mario" "apellidos" => "González Gay" ] 1 => array:2 [ "nombre" => "Amer" "apellidos" => "Zanabili Al-Sibbai" ] 2 => array:2 [ "nombre" => "Livia" "apellidos" => "Revuelta Mariño" ] 3 => array:2 [ "nombre" => "Manuel" "apellidos" => "Alonso Pérez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009739X16000622" "doi" => "10.1016/j.ciresp.2016.02.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X16000622?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507716301417?idApp=UINPBA00004N" "url" => "/21735077/0000009400000010/v1_201612221147/S2173507716301417/v1_201612221147/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173507716301557" "issn" => "21735077" "doi" => "10.1016/j.cireng.2016.07.014" "estado" => "S300" "fechaPublicacion" => "2016-12-01" "aid" => "1653" "copyright" => "AEC" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Cir Esp. 2016;94:588-94" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2371 "formatos" => array:3 [ "EPUB" => 25 "HTML" => 2041 "PDF" => 305 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Transanal Hemorrhoid Dearterialization is a Safe and Effective Outpatient Procedure for the Treatment of Hemorrhoidal Disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "588" "paginaFinal" => "594" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Desarterialización hemorroidal transanal, un procedimiento seguro y eficaz para el tratamiento ambulatorio de la enfermedad hemorroidal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1165 "Ancho" => 1203 "Tamanyo" => 62516 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">As our experience with THD increased, the frequency of complications decreased year after year.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Zoran Bjelanovic, Miroljub Draskovic, Milic Veljovic, Ivan Lekovic, Menelaos Karanikolas, Dusica Stamenkovic" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Zoran" "apellidos" => "Bjelanovic" ] 1 => array:2 [ "nombre" => "Miroljub" "apellidos" => "Draskovic" ] 2 => array:2 [ "nombre" => "Milic" "apellidos" => "Veljovic" ] 3 => array:2 [ "nombre" => "Ivan" "apellidos" => "Lekovic" ] 4 => array:2 [ "nombre" => "Menelaos" "apellidos" => "Karanikolas" ] 5 => array:2 [ "nombre" => "Dusica" "apellidos" => "Stamenkovic" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0009739X16301129" "doi" => "10.1016/j.ciresp.2016.07.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X16301129?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507716301557?idApp=UINPBA00004N" "url" => "/21735077/0000009400000010/v1_201612221147/S2173507716301557/v1_201612221147/en/main.assets" ] "en" => array:22 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Initial Results of the National Registry of Incisional Hernia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "595" "paginaFinal" => "602" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José Antonio Pereira, Manuel López-Cano, Pilar Hernández-Granados, Xavier Feliu" "autores" => array:5 [ 0 => array:4 [ "nombre" => "José Antonio" "apellidos" => "Pereira" "email" => array:1 [ 0 => "86664@parcdesalutmar.cat" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Manuel" "apellidos" => "López-Cano" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 2 => array:3 [ "nombre" => "Pilar" "apellidos" => "Hernández-Granados" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 3 => array:3 [ "nombre" => "Xavier" "apellidos" => "Feliu" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">✠</span>" "identificador" => "fn1" ] ] ] 4 => array:2 [ "colaborador" => "on behalf of the EVEREG group" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">◊</span>" "identificador" => "fn2" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía General, Hospital Universitari del Mar, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cirugía General, Hospital Vall d’Hebrón, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departament de Cirurgia, Universitat Autònoma de Barcelona, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Hospital Universitario Fundación Alcorcón, Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Hospital de Igualada, Consorci Sanitari de l’Anoia, Igualada, Barcelona, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resultados iniciales del Registro Español de Hernia Incisional" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1452 "Ancho" => 1737 "Tamanyo" => 100291 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Type of prosthesis used.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">National abdominal wall defect registries began in Sweden in 1992,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">1</span></a> taking advantage of the diffusion of information systems. Nilsson<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> in Sweden and Bay-Nielsen<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">3</span></a> in Denmark published very interesting initial results in inguinal hernias.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Due to their prevalence, clinical and economic repercussions, and the lack of agreement in their treatment and results, incisional hernias are an important pathology to be audited by means of a registry.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The first attempts at establishing national incisional hernia registries also emerged from the Nordic countries,<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a> where a multicenter study at 40 hospitals detected wide heterogeneity in treatments and results. The authors came to just one conclusion: the need for improvement. Therefore, a national registry was created.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Meanwhile, in Denmark, the Danish Ventral Hernia Database was established in 2006. Its initial published studies<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">5,6</span></a> confirmed the lack of a consensus strategy in the treatment of ventral hernia as well as relevant postoperative morbidity rates. This led to the establishment of improvement processes and the promotion of national conferences to discuss the results and reduce the variability in the processes.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Other European registries include: Herniamed<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> in Germany, which registers cases with all types of hernias; Club Hernie in France<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> (<a id="intr0010" class="elsevierStyleInterRef" href="http://www.club-hernie.com/">http://www.club-hernie.com/</a>), with all types of patients treated by a participating group of hospitals and surgeons; and, then there are the registries of the Netherlands and Belgium, which are still in early stages.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In 2011, the European Registry of Abdominal wall HerniaS (EuraHS)<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a> was created under the auspices of the European Hernia Society (EHS). This online European registry of ventral hernias is a unique and quite interesting initiative that unfortunately has not been met with successful participation.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The Spanish Registry of Incisional Hernias (known as EVEREG) was started in Catalonia in 2012. The initiative quickly extended to the rest of the country in January 2013, with the participation of the Abdominal Wall and Sutures Division of the Spanish Association of Surgeons.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The objective of the present study is to analyze the data collected in the aforementioned registry since its inception in July 2012 until March 2015 and, based on the results, to determine the current treatment status of this prevalent condition and to detect those areas susceptible to improvement where unified action strategies should be applied.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0045" class="elsevierStylePara elsevierViewall">This study provides an observational descriptive analysis of the data obtained from EVEREG since its inception until March 2015.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The central database (PostgresSQL version 8.4) used has been designed from a computerized data entry platform called OpenClinica, which is accessible through the Internet (<a id="intr0015" class="elsevierStyleInterRef" href="http://www.evereg.es/">http://www.evereg.es/</a>). On this site, is possible to anonymously record all cases of incisional hernias that have been treated surgically at the participating medical centers. The study protocol has been approved by the Ethics Committees at all the participating hospitals, and the regulations of the Organic Law on Data Protection and Patient Autonomy have been followed.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Inclusion criteria were: hernias that had appeared after laparotomy; and, recurrences after previous incisional or ventral hernia repair.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Exclusion criteria were: other types of primary ventral hernias (umbilical, epigastric, Spiegel).</p><p id="par0065" class="elsevierStylePara elsevierViewall">The introduction of a new case generates a unique identification number that is only known by the person in charge at the reporting hospital, thereby ensuring patient anonymity. The registry is for hernias and not for patients, so patients with more than one hernia, or those who have been treated repeatedly for recurrences, may be registered repeatedly. Patients receive an informed consent form for the surgery, in which they accept the collection of data related to their intervention and subsequent follow-up. The variables compiled are demonstrated in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Patients were considered to be affected by chronic pain when they presented pain related to surgery (Visual Analog Scale greater than 3) more than 6 months after the initial intervention. Recurrences were defined as all protrusions in the surgical area that the surgeon who explored the patient designated as a recurrence, as well as those diagnosed with imaging studies. Persistent suppuration of the wound more than 6 months after surgery was considered chronic infection.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Nine groups have been established based on the number of hospitals in each Spanish Autonomous Community and their geographical proximity (Andalusia, Catalonia, Madrid, Levante, Northern Zone, Castile-La Mancha, Castile-Leon, Extremadura, and Canary Islands), that meet at least every 6 months to exchange information, coordinate actions, and review results. In each of the regions, a representative has been appointed to attend an annual meeting at which actions are planned, improvements are made in data collection, and the results are reviewed cooperatively. By March 2015, a total of 113 hospitals had joined the initiative (15 tertiary hospitals, 34 general hospitals, 60 regional hospitals, and 4 private medical centers). The geographical distribution and the detailed hospital list of the hospitals can be consulted on the registry website (<a id="intr0020" class="elsevierStyleInterRef" href="http://www.evereg.es/">http://www.evereg.es</a>).</p><p id="par0080" class="elsevierStylePara elsevierViewall">The data are stored on an external server managed by a company employed for this function (SAIL, <span class="elsevierStyleItalic">Servicio de Asesoría a la Investigación y Logística</span>, Barcelona). The company financing the initiative does not have access to the stored data.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical Analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">The present study used the data provided in the periodic summaries to which the regional representatives have access. The means, standard deviations, and number of cases for each item were analyzed by the GraphPad Quick Calcs tool (GraphPad Software Inc., La Jolla, CA, USA) (<a id="intr0025" class="elsevierStyleInterRef" href="http://www.graphpad.com/quickcalcs/">http://www.graphpad.com/quickcalcs/</a>), which provided rapid statistical calculation.</p><p id="par0090" class="elsevierStylePara elsevierViewall">A univariate analysis was conducted using Fisher's exact test or the chi-squared test (<span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span>) to evaluate the association of the categorical variables and Student's <span class="elsevierStyleItalic">t</span> test for the quantitative variables. A <span class="elsevierStyleItalic">P</span><.05 was considered significant.</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0095" class="elsevierStylePara elsevierViewall">A total of 4501 hernias (1636<span class="elsevierStyleHsp" style=""></span>hernias/year) were registered between July 2012 and March 2015 at 95 of the 113 participating hospitals; demographic data were available for 4476. <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> compares the sociodemographic characteristics from the records (laparotomy vs. laparoscopy, elective vs. urgent surgery, and primary vs. recurrent repairs).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Most operations (94.4%) were conducted as scheduled surgery. Patients who underwent urgent operations were older (68.6 vs. 62.4 years, <span class="elsevierStyleItalic">P</span><.0001), predominantly women (68.3% vs. 55.9%, <span class="elsevierStyleItalic">P</span>=.0001), more frequently affected by obesity (BMI<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>) (53% vs. 45.1%, <span class="elsevierStyleItalic">P</span><.0001) and had higher surgical risk (ASA III–V 51.4% vs. 28.6%, <span class="elsevierStyleItalic">P</span><.0001). Associated intestinal resection was performed in 38 patients (15.3%) who were operated on urgently and 48 (1.1%) of those who underwent scheduled surgery.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Laparoscopic surgery was used less frequently than laparotomy (11.7% vs. 88.3%). This group presented significant differences with the laparotomy group: obesity was much more frequent (51.8% vs. 44%, <span class="elsevierStyleItalic">P</span>=.0017) and the anesthetic risk was significantly lower (ASA III–V 18.6% vs. 30.8%, <span class="elsevierStyleItalic">P</span><.0001).</p><p id="par0110" class="elsevierStylePara elsevierViewall">A significant percentage of hernias treated (22.2%) were recurrences of a previous surgery. These patients presented a significantly younger age than patients who were being treated for the first time (61.8 vs. 63 years, <span class="elsevierStyleItalic">P</span>=.0086) and were more obese (54.3% vs. 43.1%, <span class="elsevierStyleItalic">P</span><.0001).</p><p id="par0115" class="elsevierStylePara elsevierViewall">The most frequent location of the hernias was a previous midline laparotomy (<span class="elsevierStyleItalic">n</span>=2994; 66.9%). Trocar-site hernias affected 16% of patients (<span class="elsevierStyleItalic">n</span>=718), followed by subcostal (<span class="elsevierStyleItalic">n</span>=242; 5.4%), parastomal (<span class="elsevierStyleItalic">n</span>=174; 3.9%) and McBurney incisional hernias (<span class="elsevierStyleItalic">n</span>=126; 2.8%). The remaining sites affected 4.9% (<span class="elsevierStyleItalic">n</span>=220) of cases. As for the dimensions of the hernias, 3995 patient files had this datum recorded: 509 (12.74%) had a transverse diameter between 10 and 15<span class="elsevierStyleHsp" style=""></span>cm, and 233 (5.83%) had a diameter larger than 15<span class="elsevierStyleHsp" style=""></span>cm. In most cases, prostheses were used to repair the hernias. In 127 (2.8%) patients, the use of mesh patches was not documented.</p><p id="par0120" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the frequency distribution of the mesh types used. Most repairs were done with polypropylene mesh (66%), followed by composite mesh (28%). Biological implants were hardly used (<span class="elsevierStyleItalic">n</span>=30; 0.7%).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">When we analyzed only those patients who received a mesh and were treated by laparotomy (<span class="elsevierStyleItalic">n</span>=3789), the suprafascial position (onlay) was the most frequently used (<span class="elsevierStyleItalic">n</span>=1930, 50.9%). The mesh was placed in either the retromuscular or preperitoneal position (sublay) in 1380 hernias (36.4%). The mesh was used as a bridge (inlay) in 141 cases (<span class="elsevierStyleItalic">n</span>=3.7%), and 2 prostheses were implanted in different positions (combination of a suprafascial prosthesis with a second retromuscular or intraperitoneal prosthesis) in 8.9% of the operations (<span class="elsevierStyleItalic">n</span>=338). In 16.3% of all operations performed by laparotomy (<span class="elsevierStyleItalic">n</span>=617), a separation of components was required.</p><p id="par0130" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> summarizes the results of the surgical interventions of the 3759 cases for which we have postoperative data available. Mean hospital stay was 5.2 days, with a significantly longer mean stay in cases that were treated urgently (<span class="elsevierStyleItalic">P</span><.0001) and shorter stays in laparoscopic hernia repairs (<span class="elsevierStyleItalic">P</span><.0001).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Complications appeared in 29.1% of the cases. The most frequent (80.3% of the total; 879 patients) were related with the surgical incision (hematoma, seroma, and wound infection). Mortality was low (0.8%). A total of 141 patients (3.7%) were reoperated during the first 30 postoperative days. The most frequent causes of reoperation were related with the surgical wound (<span class="elsevierStyleItalic">n</span>=69; 48.9%): hematoma/hemorrhage (<span class="elsevierStyleItalic">n</span>=19); seroma (<span class="elsevierStyleItalic">n</span>=4); wound infection or necrosis (<span class="elsevierStyleItalic">n</span>=54), and others (<span class="elsevierStyleItalic">n</span>=2). Visceral complications arose in 43 cases (30.5%): intestinal perforation (<span class="elsevierStyleItalic">n</span>=16); anastomotic dehiscence (<span class="elsevierStyleItalic">n</span>=4); non-digestive visceral lesion (<span class="elsevierStyleItalic">n</span>=1); bowel obstruction (<span class="elsevierStyleItalic">n</span>=17); mesenteric ischemia (<span class="elsevierStyleItalic">n</span>=4); and hemoperitoneum (<span class="elsevierStyleItalic">n</span>=1). Lastly, 15 patients (10.6%) were reoperated for early recurrence, with an incidence of immediate relapse in the series of 0.4%.</p><p id="par0140" class="elsevierStylePara elsevierViewall">All complications were significantly higher in the group of patients that had undergone urgent surgery. With the exception of mortality, recurrent hernias had a higher rate of complications compared to primary hernias (33.7% vs. 27.8%; <span class="elsevierStyleItalic">P</span>=.0012). In laparoscopic surgery, wound infection was significantly lower than in open surgery (1.9% vs. 6.5%, <span class="elsevierStyleItalic">P</span><.0001).</p><p id="par0145" class="elsevierStylePara elsevierViewall">We have follow-up data for 1566 cases (35.0%; mean 9.5 months; median 7.7 months). Late-onset complications (chronic infection, chronic pain, or recurrence) were recorded in 316 (20.5%).</p><p id="par0150" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> shows the follow-up data distributed by groups of records that were monitored for more than 6 months (<span class="elsevierStyleItalic">n</span>=946; 24.3%; median follow-up 12.4 months), and more than one year (<span class="elsevierStyleItalic">n</span>=564; 17.9%; median follow-up 16.4 months). Of note is the high and increasing frequency of recurrences as the follow-up increases (13.2% in cases followed 6 or more months and 20.7% in follow-ups of more than one year), with a higher rate in hernias treated for recurrence of a previous repair after 6 months (<span class="elsevierStyleItalic">P</span>=.005) as well as one year (<span class="elsevierStyleItalic">P</span>=.004).</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0155" class="elsevierStylePara elsevierViewall">The analysis of the EVEREG results has corroborated the data from other incisional hernia registries<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">10,11</span></a> and has confirmed the need to register the results of this disease and probably those of other highly prevalent conditions affecting the abdominal wall.</p><p id="par0160" class="elsevierStylePara elsevierViewall">The first point for improvement of hernia registries would be participation. The voluntary registration system with external financing used in this case, as in other platforms,<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a> is not optimal. Its voluntary nature means that only the most motivated surgeons participate in this initiative. Therefore, the absence of mandatory registration in our territory probably produces a significant bias in the results, so that we are only at the tip of the iceberg of the problem. Likewise, dependence on external financing, in our case, raises doubts about the longevity of this registry.</p><p id="par0165" class="elsevierStylePara elsevierViewall">We consider the data collected to be reliable because of the motivation of the participants, but there is unequal participation, and some hospitals started out with great momentum only to lose speed over time. In this context, it would be ideal to have either an incentive to register or to make the registration of this activity mandatory or remunerated within the public healthcare system.</p><p id="par0170" class="elsevierStylePara elsevierViewall">Another problem is that hernias are collected rather than patients, and there is no possible individual follow-up. In the current situation, this is the only possible way to store the data on a non-institutional server and preserve patient privacy. This problem affects other European registries that lack the support of the public healthcare administration. However, if we consider only primary repairs, we are reasonably sure that these patients are not duplicated.</p><p id="par0175" class="elsevierStylePara elsevierViewall">The analysis of the demographic data of the cases indicates that incisional hernias appear predominantly in female patients who are older than 60, obese and have a high frequency of associated disease. This is even more pronounced in cases with urgent surgery and recurrent hernias, in which patients are more obese and have significantly higher surgical risk. Therefore, these circumstances must be taken into account during the initial laparotomy in order to maximize precautions during closure or to apply prophylactic measures.</p><p id="par0180" class="elsevierStylePara elsevierViewall">Regarding the surgical approach, the limited use of laparoscopy, which was only used in 11.7% of the cases, is noteworthy. This datum is differential in our country when compared to other registries in which laparoscopy reaches more than 50%.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> A detailed analysis of the reasons for this low use of laparoscopy and measures to increase its utilization is another area that needs improvement.</p><p id="par0185" class="elsevierStylePara elsevierViewall">A very interesting fact is that, in view of what has been collected, a large number of complex hernias were treated surgically. If we consider only recurrent hernias (considered complex by definition),<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> more than 22% of the operated hernias met this criterion. The same happened with the percentage of patients with component separation (16.3% of those operated by open surgery). All this is likely to be due to a selection bias due to the predominant participation in the registry of departments that have divisions specialized in abdominal wall surgery.</p><p id="par0190" class="elsevierStylePara elsevierViewall">The postoperative results are similar to those reported in the series of incisional hernias<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">6,10,11</span></a>: high frequency of minor wound-related complications, increased incidence of complications in urgent surgery and recurrent hernias, and low overall mortality, although especially elevated in patients undergoing urgent surgery.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">Regarding the surgical technique, it is interesting that a significant number of repairs (<span class="elsevierStyleItalic">n</span>=31) are still performed without prostheses, which, in our opinion, seems exceptional, especially when we verified that most of these patients underwent scheduled surgery. This fact has also been detected in other registries, with even higher percentages.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> Although we only have follow-up for more than one year in 9 of them, 4 relapses have been diagnosed (44.4%). Therefore, it once again seems clear that mesh should be used whenever possible in the repair of incisional hernias, as indicated in the literature.<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">14,15</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">Another notable technical fact is the clear preference of surgeons for the placement of mesh in the suprafascial (onlay) position as opposed to the preference for the retromuscular position (sublay) in the rest of Europe and in the recommendations of certain groups.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">10,16,17</span></a> This shows, as other authors indicate,<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a> that there are no unanimous criteria for the use of mesh, their position or even the fixation system.</p><p id="par0205" class="elsevierStylePara elsevierViewall">Regarding follow-up, we have observed that patients are subject to poor follow-up, which contributes to the lack of awareness of the actual results of this surgery. It is common for patients to undergo surgery and not be reviewed until one month after surgery. This is probably the main Achilles’ heel of our results, fostered by the usual dynamics of public hospitals in which patient follow-up is not at all promoted and, given the high prevalence of this disease, would be an additional work overload. Just as in neoplasms, it is clear that follow-up studies should be very long (more than 10 years), although this has not been happening in abdominal wall diseases.</p><p id="par0210" class="elsevierStylePara elsevierViewall">Finally, if we consider the figures detected by the registry, we are facing a disturbing situation of incisional hernia recurrences that affects about 20% of patients followed more than one year, with no differences among the different groups. Thus, although there are other late complications (chronic infection and chronic pain), in our opinion, currently the first objective should be to reduce the recurrence rate, as has been done in the case of inguinal hernias. This fact is not exclusive to our registry and is similar to publications by other authors.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Briefly, the main strengths of the registry are: thoroughness of the data collection; the high number of patients collected; and, the commitment of a relevant number of surgeons in the country to collaborate in the initiative. The main weakness is the lack of uniform treatment criteria and insufficient long-term follow-up, which implies that the rates of late complications need to be carefully analyzed and require updating in order to draw more reliable conclusions.</p><p id="par0220" class="elsevierStylePara elsevierViewall">To conclude, the EVEREG registry is a useful tool to determine the true situation of incisional hernia treatment in Spain. It is necessary to improve and increase data collection in the registry and, particularly, to increase patient follow-up. Also, it is essential to ensure that the largest number possible of General Surgery Departments register their data so that the analysis of the registry is as close as possible to the actual results of the country. The analysis of the data collected to date shows that it is necessary to introduce relevant improvements in the treatment of this disease, especially in terms of reducing the number of recurrences. Therefore, in addition to making progress in the case registration and updating process, comparative studies should be initiated to improve the results obtained until now.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0225" class="elsevierStylePara elsevierViewall">B. Braun has funded the design and storage costs of the EVEREG database.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicts of Interests</span><p id="par0230" class="elsevierStylePara elsevierViewall">The authors must declare if they are consultants of some prosthetic company and that entails remuneration some.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres779617" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec779255" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres779616" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec779256" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical Analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of Interests" ] 10 => array:2 [ "identificador" => "xack261069" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-05-23" "fechaAceptado" => "2016-09-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec779255" "palabras" => array:3 [ 0 => "Incisional hernia" 1 => "Registry" 2 => "Results" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec779256" "palabras" => array:3 [ 0 => "Hernia incisional" 1 => "Registros" 2 => "Resultados" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to the data from the National Registry of Incisional Hernia (EVEREG) to determine the reality of the treatment of this condition in Spain.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">EVEREG is an online prospective database which has been functioning since July 2012; operations for incisional hernia are anonymously recorded.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Up to March 2015, 4501 hernias from 95 of the 113 participating hospitals were registered. The mean age of the patients was 62.7, and 56.5% were women, with a mean BMI of 30.2<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>; 29.8% presented a high surgical risk (ASA <span class="elsevierStyleSmallCaps">III</span>–<span class="elsevierStyleSmallCaps">V</span>). A total of 93.7% were scheduled surgeries, 88.3% open surgery and 22.2% were recurrent incisional hernias. There were 66.9% hernias after a midline laparotomy, and 81.4% of a transverse diameter of less than 10<span class="elsevierStyleHsp" style=""></span>cm. A mesh was used in 96.2% of cases. Postoperative stay was 5.3 days and 29.1% presented a complication, with a mortality of 0.8%. After a median follow-up of 7.7 months a high rate of recurrence was detected (20.7% per year), especially in hernias that were operated on after a previous repair (18.1% primary vs. 30.6% recurrent; <span class="elsevierStyleItalic">P</span>=.004).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The EVEREG registry is a useful tool to know the current situation of incisional hernia treatment. Analysis of the data shows several points that could be improved: a low rate of follow-up and high recurrence rate.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio fue analizar los datos recopilados en el Registro Nacional de Hernia Incisional (EVEREG) para conocer la situación actual del tratamiento de esta dolencia en España.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">EVEREG es una base de datos prospectiva <span class="elsevierStyleItalic">online</span> en la que, desde julio de 2012, se registraron de forma anónima los datos de las hernias incisionales intervenidas en España.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Hasta marzo de 2015, se han registrado 4.501 hernias en 95 de los 113 hospitales inscritos. La edad media de los casos fue de 62,7 años, un 56,5% mujeres, con un IMC medio de 30,2<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span> y un 29,8% de ellos con riesgo quirúrgico elevado (ASA <span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">V</span>). Un 93,7% de las intervenciones fueron electivas, el 88,3% por cirugía abierta y el 22,2% fueron hernias recurrentes. El 66,9% correspondían a una hernia tras laparotomía media, en el 81,4% el diámetro transversal fue menor de 10<span class="elsevierStyleHsp" style=""></span>cm. Se empleó una prótesis en el 96,2% de los casos. La estancia postoperatoria fue de 5,3 días, con complicaciones en el 29,1% y con una mortalidad del 0,8%. Tras una mediana de seguimiento de 7,7 meses se ha detectado un elevado índice de recurrencias (20,7% al año), sobre todo en hernias intervenidas tras una reparación previa (18,1% primarias vs 30,6% recidivadas; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,004).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El registro EVEREG es una herramienta útil para conocer la situación actual del tratamiento de la hernia incisional. El análisis de los datos señala como principales elementos susceptibles de mejora el bajo índice de seguimiento y la elevada tasa de recurrencias.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:3 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pereira JA, López-Cano M, Hernández-Granados P, Feliu X, en representación del grupo EVEREG. Resultados iniciales del Registro Español de Hernia Incisional. Cir Esp. 2016;94:595–602.</p>" ] 1 => array:3 [ "etiqueta" => "✠" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">In memoriam: Xavier Feliu Pala.</p>" "identificador" => "fn1" ] 2 => array:3 [ "etiqueta" => "◊" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">The list of members of the group can be found in <a class="elsevierStyleCrossRef" href="#sec0040">Annex</a>.</p>" "identificador" => "fn2" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0240" class="elsevierStylePara elsevierViewall">Antonio Utrera González, Hospital Juan Ramón Jiménez, Huelva</p> <p id="par0245" class="elsevierStylePara elsevierViewall">José M, Capitán Vallvey, Complejo Hospitalario de Jaén, Jaén</p> <p id="par0250" class="elsevierStylePara elsevierViewall">Juan A, Bellido Luque, Hospital Riotinto, Huelva</p> <p id="par0255" class="elsevierStylePara elsevierViewall">Paloma Rey, Hospital Comarcal de la Axarquía, Málaga</p> <p id="par0260" class="elsevierStylePara elsevierViewall">Matías Pradas, Hospital Comarcal de Ronda, Ronda</p> <p id="par0265" class="elsevierStylePara elsevierViewall">Manuel Bustos, Hospital Virgen del Rocío, Sevilla</p> <p id="par0270" class="elsevierStylePara elsevierViewall">Joaquim Robres Puig, Consorci Sanitari Integral de l’Hospitalet, Barcelona</p> <p id="par0275" class="elsevierStylePara elsevierViewall">Rafael Villalobos, Hospital Arnau de Vilanova, Lérida</p> <p id="par0280" class="elsevierStylePara elsevierViewall">Lidia Blay, Hospital de Igualada, Barcelona</p> <p id="par0285" class="elsevierStylePara elsevierViewall">Marcos Solà, Hospital de Manresa, Manresa</p> <p id="par0290" class="elsevierStylePara elsevierViewall">Miguel Fernández-Layos, Hospital de Manresa, Manresa</p> <p id="par0295" class="elsevierStylePara elsevierViewall">Dolors Güell Puigcercos, Hospital de Terrassa, Terrassa</p> <p id="par0300" class="elsevierStylePara elsevierViewall">Verónica Alonso, Hospital Dos de Maig, Barcelona</p> <p id="par0305" class="elsevierStylePara elsevierViewall">Vicente Ayuso Osuna, Hospital Espíritu Santo, Santa Coloma de Gramanet</p> <p id="par0310" class="elsevierStylePara elsevierViewall">Carles Olona Casas, Hospital Joan <span class="elsevierStyleSmallCaps">XXIII</span>, Tarragona</p> <p id="par0315" class="elsevierStylePara elsevierViewall">Francisco Martínez Ródenas, Hospital Municipal de Badalona, Badalona</p> <p id="par0320" class="elsevierStylePara elsevierViewall">Vasile Veste, Hospital de Olot, Olot,</p> <p id="par0325" class="elsevierStylePara elsevierViewall">Jordi Comajuncosas, Hospital Parc Sanitari Sant Joan de Deu, Sant Boi</p> <p id="par0330" class="elsevierStylePara elsevierViewall">Carlos Javier Gómez Díaz, Hospital Parc Taulí, Sabadell</p> <p id="par0335" class="elsevierStylePara elsevierViewall">Oscar Colomer, Hospital Parc Taulí, Sabadell</p> <p id="par0340" class="elsevierStylePara elsevierViewall">Magda Abelló Sala, Hospital Pius, Valls</p> <p id="par0345" class="elsevierStylePara elsevierViewall">Carlos Houyuela Alonso, Hospital Plató, Barcelona</p> <p id="par0350" class="elsevierStylePara elsevierViewall">Francesc Marsal, Hospital Santa Tecla, Tarragona</p> <p id="par0355" class="elsevierStylePara elsevierViewall">Agustín Juan Cano Maldonado, Complejo Hospitalario Universitario, Cartagena</p> <p id="par0360" class="elsevierStylePara elsevierViewall">Juan Manuel Rueda Pérez, Complejo Hospitalario Universitario, Cartagena</p> <p id="par0365" class="elsevierStylePara elsevierViewall">Rosa Gamón, Hospital General de Castellón, Castellón</p> <p id="par0370" class="elsevierStylePara elsevierViewall">Pedro García Peche, Hospital General Universitario Reina Sofía, Elche</p> <p id="par0375" class="elsevierStylePara elsevierViewall">Miguel González Valverde, Hospital General Universitario Reina Sofía, Elche</p> <p id="par0380" class="elsevierStylePara elsevierViewall">Ramón J, Ferri, Hospital Lluís Alcanyís, Valencia</p> <p id="par0385" class="elsevierStylePara elsevierViewall">Elena Martí Ciñat, Hospital Malvarrosa, Valencia</p> <p id="par0390" class="elsevierStylePara elsevierViewall">Vicente Barbero, Complejo Hospitalario Virgen de la Salud, Toledo</p> <p id="par0395" class="elsevierStylePara elsevierViewall">Fernando Fernández Bueno, Hospital Central de la Defensa, Madrid</p> <p id="par0400" class="elsevierStylePara elsevierViewall">Isabel Delgado Lillo, Hospital Clínico San Carlos, Madrid</p> <p id="par0405" class="elsevierStylePara elsevierViewall">Juan Jesús Cabeza Gómez, Hospital Clínico San Carlos, Madrid</p> <p id="par0410" class="elsevierStylePara elsevierViewall">Joaquín Picazo Yeste, Hospital General de La Mancha, Ciudad Real</p> <p id="par0415" class="elsevierStylePara elsevierViewall">Antonio López, Hospital Nuestra Señora del Prado, Talavera de la Reina</p> <p id="par0420" class="elsevierStylePara elsevierViewall">José Luis Porrero Carro, Hospital Santa Cristina, Madrid</p> <p id="par0425" class="elsevierStylePara elsevierViewall">Teresa Butrón, Hospital Universitario 12 de Octubre, Madrid</p> <p id="par0430" class="elsevierStylePara elsevierViewall">Miguel Ángel García Ureña, Hospital Universitario del Henares, Alcalá de Henares</p> <p id="par0435" class="elsevierStylePara elsevierViewall">Marta de Mingo, Hospital Universitario Infanta Elena, Madrid</p> <p id="par0440" class="elsevierStylePara elsevierViewall">Javier Granell, Hospital Universitario Príncipe de Asturias, Alcalá de Henares</p> <p id="par0445" class="elsevierStylePara elsevierViewall">Lucas Blázquez Latre, Complejo Hospitalario de Navarra, Pamplona</p> <p id="par0450" class="elsevierStylePara elsevierViewall">Enrique Sanemeterio, Hospital Comarcal de Laredo, Santander</p> <p id="par0455" class="elsevierStylePara elsevierViewall">Esther Guisasola, Hospital Universitario, San Sebastián</p> <p id="par0460" class="elsevierStylePara elsevierViewall">Ernesto Tobalina Aguirrezábal, Hospital Universitario, Galdakao</p> <p id="par0465" class="elsevierStylePara elsevierViewall">Ángel Zorraquino, Hospital de Basurto, Bilbao</p>" "etiqueta" => "Annex" "titulo" => "Member of the EVEREG Group" "identificador" => "sec0040" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1452 "Ancho" => 1737 "Tamanyo" => 100291 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Type of prosthesis used.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Preoperative and Surgical Intervention \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Patient data</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sex \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>BMI (body mass index)(kg/m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medical and surgical history \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Toxic habits \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ASA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hernia data</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Location \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Longitudinal and transversal measurements \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Previous surgery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Recurrence \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of pneumoperitoneum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Surgery data</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Date \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Duration \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Type of prosthesis and fixation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Size of prosthesis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Use of drain tubes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Associated surgical procedures \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Intraoperative complications \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Postoperative data</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Date of admittance \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Complications and type \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pain (VAS) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Death \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Reoperation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">First postoperative visit</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Date of visit \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Complications \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pain (VAS) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Death \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Reoperation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Follow-up visits</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Date of visit \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Type of visit \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Recurrence \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chronic pain \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Chronic infection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Removal of prosthesis \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1295477.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Data Compiled in the Registry.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Data with statistically significant differences are shown in bold.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Total \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Surgery</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Approach</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Hernia</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Elective \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Urgent \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Laparotomy \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Laparoscopy \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Primary \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Recurrence \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4476 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4227 (94.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">249 (5.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3974 (88.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">527 (11.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3484 (77.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">992 (22.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62.7 (13.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">62.4 (13.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">68.6 (15.2)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.2 (13.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62.1 (13.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">63 (13.6)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">61.8 (12.4)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.009</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sex % (M/F) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43.5/56.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">44.1 (55.9)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">31.7 (68.3)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.3 (55.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37.2 (62.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 (57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.3 (54.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.88 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI kg/m<span class="elsevierStyleSup">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30.2 (5.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">30.1 (5.5)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">31.0 (6.4)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.013</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">30.5 (5.6)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">31.2 (5.4)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.007</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">29.8 (5.4)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">31.6 (5.7)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity <span class="elsevierStyleItalic">N</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2052 (45.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">1908 (45.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">132 (53.0)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">1750 (44.0)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">273 (51.8)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.0017</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">1501 (43.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">539 (54.3)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ASA <span class="elsevierStyleSmallCaps">III</span>–<span class="elsevierStyleSmallCaps">V</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1331 (29.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">1204 (28.6)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">127 (51.4)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">1226 (30.8)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">97 (18.6)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1023 (29.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">308 (31.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.30 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1295476.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Sociodemographic Characteristics of the Patients According to the Type of Surgery, Approach, and Hernia.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Statistically significant results are shown in bold.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Total \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Surgery</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Approach</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Hernia</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Elective \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Urgent \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Laparotomy \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Laparoscopy \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Primary \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Recurrence \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3759 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3540 (94.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">219 (5.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3289 (87.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">470 (12.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2952 (78.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">807 (21.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hospital stay (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.2 (8.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">4.9 (8.5)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">9.8 (11.5)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">5.5 (9.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">3.4 (6.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">5 (8.8)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">6 (8.8)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.0043</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Complications, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1094 (29.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">986 (27.9)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">108 (49.3)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">959 (29.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">135 (28.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">871 (27.8)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">272 (33.7)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.0012</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mortality, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">20 (0.6)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">9 (4.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 (0.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wound infection, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">222 (5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">187 (5.2)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">35 (17.4)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">213 (6.5)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">9 (1.9)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><.0001</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">159 (5.4)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">63 (7.8)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.011</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Reoperation within 30 days, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">141 (3.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">123 (3.5)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">18 (8.2)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.0014</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">123 (3.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.89 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">95 (3.2)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">46 (5.7)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.0016</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1295479.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Postoperative Results.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at4" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Statistically significant results are shown in bold.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Total \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Surgery</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Approach</th><th class="td" title="table-head " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Type of Hernia</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Elective \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Urgent \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Laparotomy \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Laparoscopy \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Primary \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Recurrence \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Recurrence>6<span class="elsevierStyleHsp" style=""></span>m, <span class="elsevierStyleItalic">n</span> (%) (total=946) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">125 (13.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">111 (12.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (18.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.153 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">107 (12.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (15.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.472 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">85 (11.5)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">40 (19.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.005</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Recurrence>12<span class="elsevierStyleHsp" style=""></span>m, <span class="elsevierStyleItalic">n</span> (%) (total=564) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">117 (20.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">104 (20.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (26.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.355 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 (20.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (25.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.336 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">80 (18.1)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">37 (30.6)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.004</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic pain>6<span class="elsevierStyleHsp" style=""></span>m, <span class="elsevierStyleItalic">n</span> (%) (total=946) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">131 (13.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">126 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (6.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.079 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">123 (14.7)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">8 (6.8)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">.021</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98 (13.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (15.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.366 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic infection>6<span class="elsevierStyleHsp" style=""></span>m, <span class="elsevierStyleItalic">n</span> (%) (total=946) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87 (9.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80 (9.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (9.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80 (9.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.234 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61 (8.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (12.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.077 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Withdrawal of prosthesis>12<span class="elsevierStyleHsp" style=""></span>m, <span class="elsevierStyleItalic">n</span> (%) (total=564) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (3.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (2.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.665 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (3.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (3.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (2.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (4.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.382 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1295478.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Postoperative Follow-Up and Late-Onset Complications.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib0090" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hernia registers and specialization" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Nilsson" 1 => "S. Haapaniemi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0039-6109(05)70375-3" "Revista" => array:6 [ "tituloSerie" => "Surg Clin N Am" "fecha" => "1998" "volumen" => "78" "paginaInicial" => "1141" "paginaFinal" => "1155" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9927990" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0095" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methods of repair and risk for reoperation in Swedish hernia surgery from 1992 to 1996" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Nilsson" 1 => "S. Haapaniemi" 2 => "G. Gruber" 3 => "G. Sandblom" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2168.1998.00886.x" "Revista" => array:6 [ "tituloSerie" => "Br J Surg" "fecha" => "1998" "volumen" => "85" "paginaInicial" => "1686" "paginaFinal" => "1691" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9876075" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0100" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Bay-Nielsen" 1 => "H. Kehlet" 2 => "L. Strand" 3 => "J. Malmstrøm" 4 => "F.H. Andersen" 5 => "P. Wara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(01)06251-1" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2001" "volumen" => "358" "paginaInicial" => "1124" "paginaFinal" => "1128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11597665" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0105" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incisional hernia repair in Sweden 2002" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.A. Israelsson" 1 => "S. Smedberg" 2 => "A. Montgomery" 3 => "P. Nordin" 4 => "L. Spangen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10029-006-0084-4" "Revista" => array:6 [ "tituloSerie" => "Hernia" "fecha" => "2006" "volumen" => "10" "paginaInicial" => "258" "paginaFinal" => "261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16554979" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0110" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Establishment and initial experiences from the Danish Ventral Hernia Database" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Helgstrand" 1 => "J. Rosenberg" 2 => "M. Bay-Nielsen" 3 => "H. Friis-Andersen" 4 => "P. Wara" 5 => "L.N. Jorgensen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10029-009-0592-0" "Revista" => array:6 [ "tituloSerie" => "Hernia" "fecha" => "2010" "volumen" => "14" "paginaInicial" => "131" "paginaFinal" => "135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19937076" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0115" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nationwide study of early outcomes after incisional hernia repair" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Bisgaard" 1 => "H. Kehlet" 2 => "M.B. Bay-Nielsen" 3 => "M.G. Iversen" 4 => "P. Wara" 5 => "J. Rosenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/bjs.6728" "Revista" => array:6 [ "tituloSerie" => "Br J Surg" "fecha" => "2009" "volumen" => "96" "paginaInicial" => "1452" "paginaFinal" => "1457" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19918863" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0120" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Herniamed: an internet-based registry for outcome research in hernia surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Stechemesser" 1 => "D.A. Jacob" 2 => "C. Schug-Paß" 3 => "F. Köckerling" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10029-012-0908-3" "Revista" => array:6 [ "tituloSerie" => "Hernia" "fecha" => "2012" "volumen" => "16" "paginaInicial" => "269" "paginaFinal" => "276" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22389073" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0125" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Le Club Hernie [Web portal]. Available in: <a id="intr0030" class="elsevierStyleInterRef" href="http://www.club-hernie.com/">http://www.club-hernie.com/</a>." ] ] ] 8 => array:3 [ "identificador" => "bib0130" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Muysoms" 1 => "G. Campanelli" 2 => "G.G. Champault" 3 => "A.C. DeBeaux" 4 => "U.A. Dietz" 5 => "J. Jeekel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10029-012-0912-7" "Revista" => array:6 [ "tituloSerie" => "Hernia" "fecha" => "2012" "volumen" => "16" "paginaInicial" => "239" "paginaFinal" => "250" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22527930" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0135" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nationwide prospective study of outcomes after elective incisional hernia repair" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Helgstrand" 1 => "J. Rosenberg" 2 => "H. Kehlet" 3 => "L.N. Jorgensen" 4 => "T. Bisgaard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jamcollsurg.2012.10.013" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Surg" "fecha" => "2013" "volumen" => "216" "paginaInicial" => "217" "paginaFinal" => "228" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23219350" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0140" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Danish Hernia Database; Danish Vascular Registry. Risk factors for incisional hernia repair after aortic reconstructive surgery in a nationwide study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N.A. Henriksen" 1 => "F. Helgstrand" 2 => "K.C. Vogt" 3 => "L.N. Jorgensen" 4 => "T. Bisgaard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jvs.2012.11.119" "Revista" => array:6 [ "tituloSerie" => "J Vasc Surg" "fecha" => "2013" "volumen" => "57" "paginaInicial" => "1524" "paginaFinal" => "1530" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23548175" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0145" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Criteria for definition of a complex abdominal wall hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.J. Slater" 1 => "A. Montgomery" 2 => "F. Berrevoet" 3 => "A.M. Carbonell" 4 => "A. Chang" 5 => "M. Franklim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10029-013-1168-6" "Revista" => array:6 [ "tituloSerie" => "Hernia" "fecha" => "2014" "volumen" => "18" "paginaInicial" => "7" "paginaFinal" => "17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24150721" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0150" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Death probabilities after emergency surgery of abdominal wall hernias. Still waiting for improvement" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Martínez-Serrano" 1 => "J.A. Pereira" 2 => "J.J. Sancho" 3 => "M. López-Cano" 4 => "E. Bombuy" 5 => "J. Hidalgo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00423-009-0515-7" "Revista" => array:6 [ "tituloSerie" => "Langenbecks Arch Surg" "fecha" => "2010" "volumen" => "395" "paginaInicial" => "551" "paginaFinal" => "556" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19513743" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0155" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.W. Burger" 1 => "R.W. Luijemdijk" 2 => "W.C. Hop" 3 => "J.A. Halm" 4 => "E.G. Verdaasdonk" 5 => "J. Jeekel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Surg" "fecha" => "2004" "volumen" => "240" "paginaInicial" => "578" "paginaFinal" => "583" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15383785" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0160" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Open surgical procedures for incisional hernias" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Den Hartog" 1 => "A.H. Dur" 2 => "W.E. Tuinebreijer" 3 => "R.W. Kreis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2008" "volumen" => "16" "paginaInicial" => "CD006438" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0165" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review of the surgical treatment of large incisional hernia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.B. Deerenberg" 1 => "L. Timmermans" 2 => "D.P. Hogerzeil" 3 => "J.C. Slieker" 4 => "P.H. Eilers" 5 => "J. Jeekel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10029-014-1321-x" "Revista" => array:6 [ "tituloSerie" => "Hernia" "fecha" => "2015" "volumen" => "19" "paginaInicial" => "89" "paginaFinal" => "101" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25380560" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0170" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis of sublay versus onlay mesh repair in incisional hernia surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Timmermans" 1 => "B. de Goede" 2 => "S.M. van Djik" 3 => "G.J. Kleinrensink" 4 => "J. Jeekel" 5 => "J.F. Lange" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjsurg.2013.08.030" "Revista" => array:6 [ "tituloSerie" => "Am J Surg" "fecha" => "2014" "volumen" => "207" "paginaInicial" => "980" "paginaFinal" => "988" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24315379" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack261069" "titulo" => "Acknowledgements" "texto" => "<p id="par0235" class="elsevierStylePara elsevierViewall">The authors would like to thank SAIL and Silvia Glahn (B. Braun).</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735077/0000009400000010/v1_201612221147/S2173507716301569/v1_201612221147/en/main.assets" "Apartado" => array:4 [ "identificador" => "62067" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735077/0000009400000010/v1_201612221147/S2173507716301569/v1_201612221147/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507716301569?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 20 | 3 | 23 |
| 2024 September | 38 | 7 | 45 |
| 2024 August | 42 | 8 | 50 |
| 2024 July | 36 | 7 | 43 |
| 2024 June | 27 | 8 | 35 |
| 2024 May | 21 | 3 | 24 |
| 2024 April | 34 | 5 | 39 |
| 2024 March | 68 | 11 | 79 |
| 2024 February | 36 | 2 | 38 |
| 2024 January | 19 | 2 | 21 |
| 2023 December | 43 | 7 | 50 |
| 2023 November | 43 | 18 | 61 |
| 2023 October | 29 | 5 | 34 |
| 2023 September | 18 | 4 | 22 |
| 2023 August | 22 | 5 | 27 |
| 2023 July | 13 | 3 | 16 |
| 2023 June | 28 | 2 | 30 |
| 2023 May | 23 | 2 | 25 |
| 2023 April | 24 | 0 | 24 |
| 2023 March | 28 | 3 | 31 |
| 2023 February | 25 | 3 | 28 |
| 2023 January | 24 | 7 | 31 |
| 2022 December | 35 | 1 | 36 |
| 2022 November | 32 | 5 | 37 |
| 2022 October | 34 | 11 | 45 |
| 2022 September | 35 | 4 | 39 |
| 2022 August | 31 | 6 | 37 |
| 2022 July | 34 | 12 | 46 |
| 2022 June | 29 | 5 | 34 |
| 2022 May | 21 | 4 | 25 |
| 2022 April | 16 | 10 | 26 |
| 2022 March | 33 | 8 | 41 |
| 2022 February | 37 | 8 | 45 |
| 2022 January | 50 | 11 | 61 |
| 2021 December | 38 | 12 | 50 |
| 2021 November | 62 | 10 | 72 |
| 2021 October | 41 | 18 | 59 |
| 2021 September | 47 | 7 | 54 |
| 2021 August | 30 | 8 | 38 |
| 2021 July | 32 | 15 | 47 |
| 2021 June | 31 | 10 | 41 |
| 2021 May | 37 | 6 | 43 |
| 2021 April | 85 | 18 | 103 |
| 2021 March | 55 | 6 | 61 |
| 2021 February | 33 | 7 | 40 |
| 2021 January | 33 | 9 | 42 |
| 2020 December | 45 | 13 | 58 |
| 2020 November | 37 | 8 | 45 |
| 2020 October | 21 | 7 | 28 |
| 2020 September | 31 | 8 | 39 |
| 2020 August | 41 | 13 | 54 |
| 2020 July | 31 | 9 | 40 |
| 2020 June | 36 | 18 | 54 |
| 2020 May | 33 | 15 | 48 |
| 2020 April | 21 | 3 | 24 |
| 2020 March | 26 | 9 | 35 |
| 2020 February | 35 | 4 | 39 |
| 2020 January | 26 | 11 | 37 |
| 2019 December | 34 | 11 | 45 |
| 2019 November | 22 | 9 | 31 |
| 2019 October | 37 | 6 | 43 |
| 2019 September | 24 | 1 | 25 |
| 2019 August | 35 | 2 | 37 |
| 2019 July | 32 | 19 | 51 |
| 2019 June | 48 | 7 | 55 |
| 2019 May | 85 | 59 | 144 |
| 2019 April | 43 | 13 | 56 |
| 2019 March | 14 | 7 | 21 |
| 2019 February | 23 | 1 | 24 |
| 2019 January | 19 | 5 | 24 |
| 2018 December | 18 | 9 | 27 |
| 2018 November | 18 | 3 | 21 |
| 2018 October | 14 | 2 | 16 |
| 2018 September | 38 | 2 | 40 |
| 2018 August | 13 | 2 | 15 |
| 2018 July | 4 | 2 | 6 |
| 2018 June | 9 | 3 | 12 |
| 2018 May | 15 | 3 | 18 |
| 2018 April | 16 | 0 | 16 |
| 2018 March | 8 | 0 | 8 |
| 2018 February | 6 | 0 | 6 |
| 2018 January | 6 | 1 | 7 |
| 2017 December | 17 | 3 | 20 |
| 2017 November | 9 | 1 | 10 |
| 2017 October | 7 | 0 | 7 |
| 2017 September | 9 | 3 | 12 |
| 2017 August | 18 | 3 | 21 |
| 2017 July | 13 | 2 | 15 |
| 2017 June | 19 | 0 | 19 |
| 2017 May | 16 | 2 | 18 |
| 2017 April | 14 | 5 | 19 |
| 2017 March | 6 | 7 | 13 |
| 2016 December | 1 | 5 | 6 |
Show all
