Document Detail


Comparable results with 3-year follow-up for large-pore versus small-pore meshes in open incisional hernia repair.
MedLine Citation:
PMID:  20381107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Decreasing the amount of polypropylene by increasing pore size produces a lighter weight mesh that may improve tissue ingrowth and, functional properties of the abdominal wall and diminish mesh-related complications. It was the aim of this prospective observational cohort study to analyze the outcome of incisional hernia repair using small-pore versus large-pore meshes and using a standardized, open, retromuscular surgical technique. METHODS: Across a 6-year period we analyzed 205 patients treated with a heavyweight mesh (group I) and 235 patients treated with a large-pore mesh (group II) for incisional hernias. Patients with a body mass index greater than 40 kg/m(2) and patients with hernias with a transverse diameter of more than 10 cm were not treated by a retromuscular mesh repair and are not included in this analysis. Recurrent incisional hernias also were not included. Both groups had 3 years of follow-up. Patients were evaluated for pain, discomfort, feeling of foreign material, and recurrences. RESULTS: Pre-operative characteristics were comparable between the groups, including body mass index, diabetes, and smoking. The mean total hernia surface was 56 cm(2) for group I versus 48 cm(2) in group II. The mesh surface area was 448 cm(2) for group I and 425 cm(2) for group II. Considering pain scores, there was only a minor difference between the 2 groups at 1-month follow-up, at which time, the Visual Analogue Scale was 5.8 in group I and 4.9 in group II (P = .16). All other scores were comparable between the groups. In group I, 7 recurrences (3.4%) were recorded after 3 years, of which 6 were already apparent 1 year after initial repair. In group II, 9 recurrences (3.8%) were diagnosed, again 6 within the first year after repair. CONCLUSION: Large-pore meshes can be used safely for open primary incisional hernia repair with an equal outcome compared with small-pore meshes in nonobese patients with defects smaller than 10 cm in width, in regard to both recurrence rates and chronic discomfort.
Authors:
Frederik Berrevoet; Leander Maes; Luc De Baerdemaeker; Xavier Rogiers; Roberto Troisi; Bernard de Hemptinne
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-04-08
Journal Detail:
Title:  Surgery     Volume:  148     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-18     Completed Date:  2010-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  969-75     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
Affiliation:
Department of General and Hepatobiliary Surgery, University Hospital Medical School, Ghent, Belgium. frederik.berrevoet@Ugent.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Follow-Up Studies
Hernia, Abdominal / surgery*
Humans
Male
Middle Aged
Postoperative Complications / surgery*
Surgical Mesh* / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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