scholarly journals Mesh fixation to fascia during incisional hernia repair results in increased prevalence of pain at long-term follow up: a multicenter propensity score matched prospective observational study

2021 ◽  
Author(s):  
Andreas Kohler ◽  
Joël L. Lavanchy ◽  
Rahel Gasser ◽  
Roland Wyss ◽  
Lars Nowak ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Propensity Score ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Mesh Fixation ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Long Term Follow Up

Abstract Background Patient-reported outcomes such as postoperative pain are critical for the evaluation of outcomes after incisional hernia repair. The aim of this study is to determine the long-term impact of mesh fixation on postoperative pain in patients operated by open and laparoscopic technique. Methods A multicenter prospective observational cohort study was conducted from September 2011 until March 2016 in nine hospitals across Switzerland. Patients undergoing elective incisional hernia repair were included in this study and stratified by either laparoscopic or open surgical technique. Propensity score matching was applied to balance the differences in baseline characteristics between the treatment groups. Clinical follow-up was conducted 3, 12 and 36 months postoperatively to detect hernia recurrence, postoperative pain and complications. Results Three-hundred-sixty-one patients were included into the study. No significant differences in hernia recurrence and pain at 3, 12 and 36 months postoperatively were observed when comparing the laparoscopic with the open treatment group. Mesh fixation by sutures to fascia versus other mesh fixation led to significantly more pain at 36 months postoperatively (32.8% vs 15.7%, p = 0.025). Conclusions At long-term follow-up, no difference in pain was identified between open and laparoscopic incisional hernia repair. Mesh fixation by sutures to fascia was identified to be associated with increased pain 36 months after surgery. Omitting mesh fixation by sutures to the fascia may reduce long-term postoperative pain after hernia repair.

Laparoscopic Versus Open Incisional Hernia Repair: Long-Term Follow-up Results of a Randomized Clinical Trial

2021 ◽  
Author(s):  
Francisco Asencio ◽  
Juan Carbó ◽  
Ramón Ferri ◽  
Salvador Peiró ◽  
Javier Aguiló ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Randomized Clinical Trial ◽  
Incisional Hernia Repair ◽  
Long Term Follow Up

scholarly journals Long-Term Follow-Up of Lichtenstein Repair of Inguinal Hernia in the Morbid Patients With Self-Gripping Mesh (ProgripTM)

2021 ◽  
Vol 8 ◽  
Author(s):  
Weiyu Zhang ◽  
Yixin Zhao ◽  
Xiangyu Shao ◽  
Tao Cheng ◽  
Zhenling Ji ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Hernia Recurrence ◽  
The Self ◽  
Long Term Follow Up ◽  
Lichtenstein Procedure ◽  
The Mean

Objective: This study aimed to demonstrate the safety and the efficacy of the self-gripping mesh (ProgripTM) for inguinal hernia repair in morbid patients of the higher American Society of Anesthesiologists (ASA) classification (ASA III and IV). The incidence of chronic pain, postoperative complications, and hernia recurrence was evaluated.Methods: Data were collected retrospectively from the files of the patient and were analyzed for 198 hernias in 147 patients. All the patients included in this study had undergone inguinal hernia repair by Lichtenstein approach with the self-gripping mesh (ProgripTM) in the same clinical center. Preoperative, perioperative, and postoperative data were collected and a long-term follow-up of 31.8 ± 19.5 m (5–60 m) was performed. Complications, pain scored on a 0–10 numeric rating scale (NRS), and hernia recurrence were assessed.Results: During the past 5 years, 198 hernias in 147 patients were repaired with the Lichtenstein procedure with the self-gripping mesh (ProgripTM). The majority of the patients were high level of the ASA classification (ASA III and IV) (95.9%), with ASA III (10.2%) and IV (85.7%). The mean operation time was 71.2 ± 23.8 min. The mean length of postoperative stay was 2.5 ± 2.1 days. There were no intraoperative complications. About 14 cases (7.1%) suffered from postoperative surgical wound complications, which were limited to the skin and subcutaneous tissue and were cured with the conservative methods successfully; there was no mesh infection, the acute postoperative pain was low or mild [visual analog scale (VAS) score ≤ 4] and the chronic postoperative pain was reported in three patients (1.5%) and tolerable, hernia recurrence (femoral hernia recurrence) occurred in one patient half a year after during the follow-up period.Conclusion: This study demonstrated the advantages of the self-gripping mesh in hernia repair of the high-risk patients with inguinal hernia (ASA III and IV) by Lichtenstein procedure under local anesthesia.

Long-Term Follow-Up of Technical Outcomes for Incisional Hernia Repair

2010 ◽  
Vol 210 (5) ◽  
pp. 648-655 ◽  
Author(s):  
Mary T. Hawn ◽  
Christopher W. Snyder ◽  
Laura A. Graham ◽  
Stephen H. Gray ◽  
Kelly R. Finan ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Long Term Follow Up

Lateral Incisional Hernia Repair by the Retromuscular Approach with Polyester Standard Mesh: Topographic Considerations and Long-term Follow-up of 61 Consecutive Patients

2012 ◽  
Vol 37 (3) ◽  
pp. 538-544 ◽  
Author(s):  
Nicolas Veyrie ◽  
Tigran Poghosyan ◽  
Nicola Corigliano ◽  
Guillaume Canard ◽  
Stephane Servajean ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Long Term Follow Up

Long-term follow-up after incisional hernia repair: are there only benefits for symptomatic patients?

Hernia ◽  
2012 ◽  
Vol 17 (2) ◽  
pp. 203-209 ◽  
Author(s):  
J. C. Lauscher ◽  
J. C. Loh ◽  
S. Rieck ◽  
H. J. Buhr ◽  
J. P. Ritz
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Long Term Follow Up

scholarly journals Long-term follow-up of full-thickness skin grafting in giant incisional hernia repair: a randomised controlled trial

Hernia ◽  
2021 ◽  
Author(s):  
V. Holmdahl ◽  
B. Stark ◽  
L. Clay ◽  
U. Gunnarsson ◽  
K. Strigård
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Skin Grafting ◽  
Full Thickness ◽  
Thickness Skin ◽  
Sf 36 ◽  
Long Term Follow Up

Abstract Purpose Conventional repair of a giant incisional hernia often requires implantation of a synthetic mesh (SM). However, this surgical procedure can lead to discomfort, pain, and potentially serious complications. Full-thickness skin grafting (FTSG) could offer an alternative to SM, less prone to complications related to implantation of a foreign body in the abdominal wall. The aim of this study was to compare the use of FTSG to conventional SM in the repair of giant incisional hernia. Methods Patients with a giant incisional hernia (> 10 cm width) were randomised to repair with either FTSG or SM. 3-month and 1-year follow-ups have already been reported. A clinical follow-up was performed 3 years after repair, assessing potential complications and recurrence. SF-36, EQ-5D and VHPQ questionnaires were answered at 3 years and an average of 9 years (long-term follow-up) after surgery to assess the impact of the intervention on quality-of-life (QoL). Results Fifty-two patients were included. Five recurrences in the FTSG group and three in the SM group were noted at the clinical follow-up 3 years after surgery, but the difference was not significant (p = 0.313). No new procedure-related complication had occurred since the one-year follow-up. There were no relevant differences in QoL between the groups. However, there were significant improvemnts in both physical, emotional, and mental domains of the SF-36 questionnaire in both groups. Conclusion The results of this long-term follow-up together with the results from previous follow-ups indicate that autologous FTSG as reinforcement in giant incisional hernia repair is an alternative to conventional repair with SM. Trial Registration The study was registered August 10, 2011 at ClinicalTrials.gov (ID NCT01413412), retrospectively registered.

scholarly journals Outcomes of Incisional Hernia Repair Surgery After Multiple Re-recurrences: A Propensity Score Matched Analysis

2021 ◽  
Author(s):  
Dimitri Sneiders ◽  
Gijs H. J. de Smet ◽  
Floris den Hartog ◽  
Yagmur Yurtkap ◽  
Anand G. Menon ◽  
...  
Keyword(s):  
Propensity Score ◽  
Incisional Hernia ◽  
Incisional Hernia Repair ◽  
Recurrent Hernia ◽  
Control Group ◽  
Baseline Characteristics ◽  
Biological Situation ◽  
Similar Risk

Abstract Background Patients with a re-recurrent hernia may account for up to 20% of all incisional hernia (IH) patients. IH repair in this population may be complex due to an altered anatomical and biological situation as a result of previous procedures and outcomes of IH repair in this population have not been thoroughly assessed. This study aims to assess outcomes of IH repair by dedicated hernia surgeons in patients who have already had two or more re-recurrences. Methods A propensity score matched analysis was performed using a registry-based, prospective cohort. Patients who underwent IH repair after ≥ 2 re-recurrences operated between 2011 and 2018 and who fulfilled 1 year follow-up visit were included. Patients with similar follow-up who underwent primary IH repair were propensity score matched (1:3) and served as control group. Patient baseline characteristics, surgical and functional outcomes were analyzed and compared between both groups. Results Seventy-three patients operated on after ≥ 2 IH re-recurrences were matched to 219 patients undergoing primary IH repair. After propensity score matching, no significant differences in patient baseline characteristics were present between groups. The incidence of re-recurrence was similar between groups (≥ 2 re-recurrences: 25% versus control 24%, p = 0.811). The incidence of complications, as well as long-term pain, was similar between both groups. Conclusion IH repair in patients who have experienced multiple re-recurrences results in outcomes comparable to patients operated for a primary IH with a similar risk profile. Further surgery in patients who have already experienced multiple hernia re-recurrences is justifiable when performed by a dedicated hernia surgeon.

Is Onlay Polypropylene Mesh Repair an Available Option for Incisional Hernia Repair? A Retrospective Cohort Study

2019 ◽  
Vol 85 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Oscar Cano-Valderrama ◽  
JosÉ L. Porrero ◽  
Esther Quirós ◽  
Oscar Bonachia ◽  
MarÍA J. Castillo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Surgical Procedures ◽  
Polypropylene Mesh ◽  
Mesh Repair ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Onlay Mesh

Lately, incisional hernia repair (IHR) with onlay polypropylene mesh has been replaced by other surgical procedures. The aim of this study was to compare the complication and recurrence rate after onlay mesh repair and other surgical procedures for IHR. A retrospective cohort study of patients who underwent IHR in a single center was conducted. The data were obtained from electronic medical records. Patients who had been lost during follow-up were contacted for a visit in the clinic. Univariate and multivariate analysis was performed with Stata 13.0 to analyze the factors associated with postoperative complications and hernia recurrence. Between June 2004 and December 2015, 1078 patients underwent IHR in a single center. Onlay mesh repair was performed in 125 patients (11.6%). Other surgical procedures included Rives procedure (29.3%), sublay mesh repair (38.6%), intrabdominal mesh repair (17.1%), and primary closure (3.4%). After a mean follow-up of 2.8 years, 73 (7%) patients developed a recurrence. A higher percentage of complications were seen after onlay mesh repair than after other surgical procedures (22.4% vs 13.1%, P = 0.005). Nevertheless, recurrence was less frequent after onlay mesh repair (4.2% vs 7.1%, P = 0.241). Logistic regression discarded an association between onlay mesh repair and hernia recurrence or postoperative complications. Incisional hernia repair with onlay polypropylene mesh repair was not associated with a higher incidence of postoperative complications or recurrence rate. So, this procedure should not be discarded in selected patients presenting with incisional hernia.

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