scholarly journals O13 BIOLOGIC VERSUS SYNTHETIC MESH IN VENTRAL HERNIA REPAIR: PARTICIPANT-LEVEL ANALYSIS OF TWO RANDOMIZED CONTROLLED TRIALS AT ONE YEAR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Naila Dhanani ◽  
Oscar Olavarria ◽  
Kyung Hyun Lee ◽  
Charlotte Young ◽  
Frank Primus ◽  
...  

Abstract Aim Biologic mesh has been increasingly utilized in complex ventral hernia repair despite limited evidence at low risk of bias supporting its growth. We hypothesized biologic mesh when compared to synthetic mesh would have fewer major complications at one year. Material and Methods We performed a participant-level meta-analysis of published randomized controlled trials (RCTs) comparing biologic to synthetic mesh at one year. Primary outcome was major complication (composite of mesh infection, recurrence, reoperation, or death) at one year post-operative. Secondary outcomes included length of index hospital stay, surgical site occurrence, and surgical site infection. Outcomes were assessed using frequentist generalized linear models. Results A total of 252 patients from two RCTs were included, 126 patients randomized to the intervention arm of biologic mesh and 126 patients randomized to the control of synthetic mesh. Median follow-up was 15 (12, 27) months. Major complication occurred in 41 (33%) patients randomized to biologic mesh, and 44 (35%) patients randomized to synthetic mesh, (relative risk [RR] 0.91, 95% confidence interval [CI] 0.54-1.55, p-value 0.740). There were 36 total recurrences, 23 (18%) in the biologic arm, and 13 (10%) in the synthetic arm (RR 1.83, 95% CI 0.84-3.99, p-value 0.130). The remainder of outcomes demonstrated no statistically significant differences. Conclusions The risk of major complication did not differ between biologic versus synthetic mesh. In patients undergoing ventral hernia repair, there was no clinical benefit with biologic mesh as opposed to synthetic mesh at one year post-operative.

2017 ◽  
Vol 18 (6) ◽  
pp. 647-658 ◽  
Author(s):  
Julie L. Holihan ◽  
Craig Hannon ◽  
Christopher Goodenough ◽  
Juan R. Flores-Gonzalez ◽  
Kamal M. Itani ◽  
...  

Author(s):  
Rayan Alsadiqi ◽  
Abdullah Albishri ◽  
Ahmad Almaghrabi ◽  
Badr Aljedaani ◽  
Khalid Alghamdi ◽  
...  

From the patient’s perspective, a ventral hernia can cause pain, adversely affect function, increase size, cosmetically distort the abdomen, and incarcerate/strangulate abdominal contents. The only known cure for a ventral hernia is surgical repair. The purpose of the current analysis was to review the published randomized controlled trials (RCTs) of the surgical care of ventral hernia. We conducted this meta-analysis using a comprehensive search of EMBASE, MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials till 01 March 2018 for randomized controlled trials on the use of mesh reinforcement in abdominal wall hernia repair. 15 studies met the search criteria, laparoscopic repair (OR 0.59; 95% CI 0.02–6.71) had the highest probability of having the lowest rate of surgical site infection. Among open mesh repair techniques, sublay repair (OR 1.41; 95% CI 0.01–5.99) had the highest probability of being the best treatment. Among patients experiencing ventral hernia repair, mesh reinforcement ought to be used regularly when there is no infection. Sublay mesh might outcome in fewer reappearances and surgical site infections. The quality of evidence to support these recommendations is moderate to high.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hobart W. Harris ◽  
Frank Primus ◽  
Charlotte Young ◽  
Jonathan T. Carter ◽  
Matthew Lin ◽  
...  

2020 ◽  
Vol 230 (4) ◽  
pp. 405-413 ◽  
Author(s):  
Jeremy Warren ◽  
Shivani S. Desai ◽  
Nicole D. Boswell ◽  
Benjamin H. Hancock ◽  
Hamza Abbad ◽  
...  

Surgery ◽  
2016 ◽  
Vol 160 (6) ◽  
pp. 1517-1527 ◽  
Author(s):  
Ciara R. Huntington ◽  
Tiffany C. Cox ◽  
Laurel J. Blair ◽  
Samuel Schell ◽  
David Randolph ◽  
...  

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