Document Detail


Total extraperitoneal hernioplasty: does the long-term clinical course depend on the type of mesh?
MedLine Citation:
PMID:  19105667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Implantation of alloplastic material has become a standard surgical procedure in inguinal hernia repair. The properties of different meshes are discussed as determinants of postoperative outcome. The aim of this study was to comparatively evaluate long-term results after total extraperitoneal hernioplasty (TEP) with a heavyweight polypropylene mesh (PP) and a lightweight polypropylene-polyglactin composite mesh (PP-PG) in a large patient population. MATERIALS AND METHODS: The study included patients who underwent TEP for elective repair of uni- or bilateral inguinal hernias between June 1997 and October 2004. We used a heavyweight PP mesh from June 1997 to February 2001 and a lightweight PP-PG mesh from March 2001 to October 2004. Patient data were evaluated by a prospective online registry, and long-term results were assessed by standardized ad hoc questionnaires after a minimum follow-up of 12 (12-103) months. RESULTS: Five hundred twenty-two patients aged 18-87 years underwent surgical repair of 655 inguinal hernias, and 370 (70.8%) were evaluated. TEP was performed with PP mesh in 192 cases and with PP-PG mesh in 169 cases. Nine patients died during follow-up; 14.6% (PP) versus 20.1% (PP-PG) patients complained of mild pain, and 8.9% (PP) versus 5.3% (PP-PG) patients reported moderate to severe pain (P > 0.05). Mild dysesthesias occurred in 13.5% of the PP group and 11.8% of the PP-PG group (P = 0.63). Moderate to severe dysesthesias were reported by 6.8% with a heavyweight mesh and by 3.0% with a lightweight mesh (P = 0.10). There were no significant differences with regard to the patients' postoperative return to normal daily activities. The recurrence rate was 5.2% with a PP mesh and 1.8% with a PP-PG mesh (P = 0.08). CONCLUSIONS: The long-term results after TEP showed no difference between PP and PP-PG meshes with regard to chronic pain, chronic dysesthesias, postoperative daily activities, and recurrence rates.
Authors:
Johannes C Lauscher; Kamal Yafaei; Heinz J Buhr; Jörg P Ritz
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  18     ISSN:  1092-6429     ISO Abbreviation:  J Laparoendosc Adv Surg Tech A     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-24     Completed Date:  2009-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  803-8     Citation Subset:  IM    
Affiliation:
Department of General, Vascular, and Thoracic Surgery, Charité-Universitätsmedizin, Campus Benjamin Franklin, Hindenburgdamm 30, Berlin, Germany. johannes.lauscher@charite.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Hernia, Inguinal / surgery*
Humans
Male
Middle Aged
Pain Measurement
Polyglactin 910
Polypropylenes
Postoperative Complications
Prospective Studies
Quality of Life
Questionnaires
Recurrence
Registries
Statistics, Nonparametric
Surgical Mesh*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Polypropylenes; 34346-01-5/Polyglactin 910

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


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