scholarly journals C-reactive protein is a predictive factor for complications after incisional hernia repair using a biological mesh

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julien Janet ◽  
Sophiane Derbal ◽  
Sylvaine Durand Fontanier ◽  
Stephane Bouvier ◽  
Niki Christou ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Biological Mesh ◽  
C Reactive Protein ◽  
Hernia Surgery ◽  
Reactive Protein ◽  
Wbc Count ◽  
Complications And Mortality

AbstractThe introduction of biological or absorbable synthetic meshes has provided an alternative to conventional repair for incisional hernia. The ability to predict the development of complications after hernia surgery is important, as it guides surgical planning and patient management. This retrospective study assessed whether the postoperative C-reactive protein (CRP) level can predict complications after incisional hernia repair using biological mesh reinforcement. Patients who underwent incisional hernia repair surgery using biological meshes between February 2009 and February 2015 were screened for study inclusion. Patients included in the study were divided into two groups: those with and without postoperative complications. The two groups were analysed based on sex, surgical operation, length of intensive care unit stay (ICU), complications and mortality. Laboratory values, including white blood cell (WBC) count and CRP levels, were determined preoperatively and up to postoperative day (POD) 10. Postoperative complications requiring further management occurred in 32 of the 60 patients (53.3%). Among 47 patients, the mean CRP and WBC levels were 6.6 mg/L and 9.073 G/L in the group without complications vs. 141.0 mg/L, 16.704 G/L in the group with complications (p < 0.001). Patients with complications also had a longer ICU stay (10.1 vs. 0.6 days, p < 0.0001). A cut-off was 101 mg/L and offered 80.00% sensitivity (IC 61.43% to 92.29) and 95.24% specificity (76.18% to 99.88%) for postoperative complication. The rate of postoperative complications before POD10 was 95% in the group with CRP > 100 mg/L vs. 46% in the group with CRP < 100 mg/L (p = 0.000372). A high postoperative CRP level (> 100 mg/L) up to POD10 may serve as a predictor of postoperative complications in patients undergoing incisional hernia using biological meshes.

scholarly journals OV10 LAPAROSCOPIC-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN HERNIA SURGERY - HOW WE DO IT

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Mário Rui Gonçalves ◽  
Conceição Antunes ◽  
Mariana Capinha ◽  
Ana Rita Arantes ◽  
Paulo Almeida ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Incisional Hernia Repair ◽  
Transversus Abdominis ◽  
Direct Visualization ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Hernia Surgery ◽  
Surgical Department

Abstract Aim “COVID has been a great challenge for Hospitals around the world. At our surgical department a new protocol of TAP block was designed and implemented in our laparoscopic incisional ventral hernia repairs, to allow these patients to be operated in ambulatory regime, without compromising pain control and the outcomes. In this video we aim to present the technique for the Laparoscopic-guided TAP Block during a Laparoscopic IPOM Plus ventral hernia repair.” Material and Methods “We implemented this protocol in July 2020 and since then, we performed 18 TAP block in laparoscopic incisional hernia repairs, laparoscopic guided by the Surgeon or ultrasound-guided by the Anesthesiologist. In this case, the video reports to a Laparoscopic IPOM Plus incisional hernia repair performed on a 54-year-old patient, male, with obesity, arterial hypertension and dyslipidemia. He had a 6 centimeter incisional hernia post-colorectal surgery in 2013.” Results “As detailed in the video, we show all the steps to perform a TAP block under laparoscopic direct visualization” Conclusions “TAP block can be performed by the Surgeon, with direct visualization at the beginning of the laparoscopic procedure.”

Cost analysis of incisional hernia repair with synthetic mesh and biological mesh: an Italian study

2017 ◽  
Vol 69 (3) ◽  
pp. 375-381 ◽  
Author(s):  
Sabrina Rampado ◽  
Andrea Geron ◽  
Giovanni Pirozzolo ◽  
Angelica Ganss ◽  
Elisa Pizzolato ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Cost Analysis ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Synthetic Mesh ◽  
Biological Mesh ◽  
Italian Study

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.

Increased risk of postoperative complications with retromuscular mesh placement in emergency incisional hernia repair: A nationwide register-based cohort study

2020 ◽  
pp. 145749692096623
Author(s):  
N. Juul ◽  
N. A. Henriksen ◽  
K. K. Jensen
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Secondary Outcome ◽  
Emergency Setting ◽  
Mesh Placement ◽  
Increased Risk ◽  
Elective Repair ◽  
Onlay Mesh

Introduction: Incisional hernia is common after abdominal surgery. Watchful waiting carries the risk of incarceration and a need for emergency intervention. The aim of this study was to examine the risk of postoperative complications after emergency versus elective incisional hernia repair. Methods: Patients above 18 years of age undergoing open incisional hernia repair in Denmark in 2017–2018 were identified in the Danish Ventral Hernia Database. Patients were grouped according to elective or emergency hernia repair. The primary outcome was postoperative complications requiring operative intervention within 90 days, and the secondary outcome was postoperative length of stay. Results: We included 1050 patients, of whom 882 were admitted for elective and 168 for emergency operation. Patients undergoing emergency repair were older (64.7 years vs 59.2 years, p < 0.001), more often smokers (25.8% vs 13.6%, p = 0.003), and more often had a Charlson comorbidity score ⩾2 (26.8% vs 19.2%, p = 0.005) compared to patients undergoing elective repair. In a multivariate regression analysis, emergency compared to elective operation (OR = 2.71, 95% CI = 1.4–5.25, p = 0.003) and retromuscular compared to onlay mesh placement (OR = 2.14, 95% CI = 1.08–4.24, p = 0.013) were factors significantly associated with increased risk of postoperative complications. In a subgroup analysis including only emergency repairs, risk of complications after retromuscular mesh placement was even higher (OR = 10.12, 95% CI = 1.81–56.68, p = 0.008). Conclusion: Emergency incisional hernia repair was associated with increased risk of postoperative complications and this risk was accentuated with retromuscular mesh placement. The use of retromuscular mesh in the emergency setting should be avoided, and the abdominal wall could either be closed by sutures or additional onlay mesh.

scholarly journals Impact of obesity on postoperative complications after laparoscopic and open incisional hernia repair – A prospective cohort study

2017 ◽  
Vol 48 ◽  
pp. 220-224 ◽  
Author(s):  
Patrick Hamid Alizai ◽  
Anne Andert ◽  
Eric Lelaona ◽  
Ulf Peter Neumann ◽  
Christian Daniel Klink ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Incisional Hernia Repair

scholarly journals Patient-reported outcomes after incisional hernia repair

Hernia ◽  
2021 ◽  
Author(s):  
N. van Veenendaal ◽  
M. M. Poelman ◽  
B. van den Heuvel ◽  
B. J. Dwars ◽  
W. H. Schreurs ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Patient Reported Outcomes ◽  
Incisional Hernia Repair ◽  
Hernia Surgery ◽  
Incisional Hernias ◽  
Patient Reported ◽  
Postoperative Symptoms

Abstract Purpose Patient-reported outcomes (PROs) are pivotal to evaluate the efficacy of surgical management. Debate persists on the optimal surgical technique to repair incisional hernias. Assessment of PROs can guide the selection of the best management of patients with incisional hernias. The objective of this cohort study was to present the PROs after incisional hernia repair at long term follow-up. Methods Patients with a history of incisional hernia repair were seen at the out-patient clinic to collect PROs. Patients were asked about the preoperative indication for repair and postoperative symptoms, such as pain, feelings of discomfort, and bulging of the abdominal wall. Additionally, degree of satisfaction was asked and Carolina Comfort Scales were completed. Results Two hundred and ten patients after incisional hernia repair were included with a median follow-up of 3.2 years. The main indication for incisional hernia repair was the presence of a bulge (60%). Other main reasons for repair were pain (19%) or discomfort (5%). One hundred and thirty-two patients (63%) reported that the overall status of their abdominal wall had improved after the operation. Postoperative symptoms were reported by 133 patients (63%), such as feelings of discomfort, pain and bulging. Twenty percent of patients reported that the overall status of their abdominal wall was the same, and 17% reported a worse status, compared to before the operation. Ten percent of the patients would not opt for operation in hindsight. Conclusion This study showed that a majority of the patients after incisional hernia repair still report pain or symptoms such as feelings of discomfort, pain, and bulging of the abdominal wall 3 years after surgery. Embedding patients’ expectations and PROs in the preoperative counseling discussion is needed to improve decision-making in incisional hernia surgery.

scholarly journals P101 BIOSYNTHETIC MESH LIMITS ADHESION FORMATION FOLLOWING INCISIONAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Gillian Manchip ◽  
Alex Shaw ◽  
Sarah Herrick
Keyword(s):  
Animal Models ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Experimental Animal ◽  
Adhesion Formation ◽  
Incisional Hernia Repair ◽  
Biological Mesh ◽  
High Rate ◽  
Experimental Animal Models ◽  
Surgical Meshes

Abstract Aim Adhesions are fibrous bands of scar tissue that form following peritoneal injury, commonly intra-abdominal surgery, and are associated with serious morbidity such as small bowel obstruction and pain. Surgical meshes used for incisional hernia repair are associated with increased incidence and severity of adhesions. There is limited consensus on which mesh may induce the least adhesions following incisional hernia repair, and most previous data has come from experimental animal models. We aimed to evaluate existing primary research to investigate whether biological mesh limits adhesion formation compared to synthetic or biosynthetic mesh when used in patients for incisional hernia repair and also to assess whether there is correlation with existing animal model data. Material and Methods A systematic search was conducted on PubMed and EMBASE. The number of mesh-related adhesions, character of adhesions and adhesion-related complications were documented. Results were compared to previously published results from animal models. Results Thirty-two studies were included, 11 of which did not document whether the adhesions were mesh related. A total of 14,161 participants underwent incisional hernia repair, 8,526 of whom were included in follow-up analysis. Overall, 9.7% developed adhesions. Biological mesh induced a high rate of dense adhesions, whereas biosynthetic mesh induced loose, filmy adhesions suggested to cause fewer complications. These findings were similar to findings from experimental animal models. Conclusions Bio-synthetic mesh was superior in causing fewer and less dense adhesions. Further analysis of mesh-induced adhesion formation on a larger scale is required to fully understand the consequences of different mesh types.

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