scholarly journals O45 OUTCOMES OF INCISIONAL HERNIA REPAIR SURGERY AFTER MULTIPLE RE-RECURRENCES: A PROPENSITY SCORE MATCHED ANALYSIS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Dimitri Sneiders ◽  
Gijs de Smet ◽  
Floris den Hartog ◽  
Yagmur Yurtkap ◽  
Anand Menon ◽  
...  
Keyword(s):  
Propensity Score ◽  
Incisional Hernia ◽  
Incisional Hernia Repair ◽  
Recurrent Hernia ◽  
Control Group ◽  
Baseline Characteristics ◽  
Biological Situation ◽  
Similar Risk

Abstract Aim 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. Material and 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. Conclusions 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.

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.

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.

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

Treatment of AML Relapse After Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) Using Low-Dose Azacitidine (AZA).

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3445-3445
Author(s):  
Alexandre Chiattone ◽  
Rima M Saliba ◽  
Borje S. Andersson ◽  
Sergio Giralt ◽  
Manish R Sharma ◽  
...  
Keyword(s):  
Low Dose ◽  
Conflicts Of Interest ◽  
Disease Free Survival ◽  
Control Group ◽  
Hematopoietic Stem ◽  
Dismal Prognosis ◽  
Baseline Characteristics ◽  
And Control

Abstract Abstract 3445 Background: Relapsing AML/MDS after HSCT has a dismal prognosis, with few patients achieving long-term control of the malignancy. AZA is a hypomethylating agent that is moderately active against AML/MDS, and may have beneficial immunomodulatory effects after HSCT. We have shown that a significant minority of patients with recurrent disease respond to this drug. Here, we present long-term follow-up after salvage treatment regimens that included AZA, to treat AML/MDS that recurred after HSCT. Patients and Methods: Twenty-three patients received low-dose AZA for recurrence. Decision to use AZA was based on clinical assessment of slow progression of disease and relatively slower disease ‘tempo' and relatively small AML bulk. AZA cohort preparative regimens for 1st HSCT were myeloablative in 12 cases, and of reduced intensity in 11 cases. AZA was used prior to or without a 2nd HSCT (n=17), or after a 2nd HSCT (n=6). Outcomes were compared to controls (n=18) that relapsed ≥ 8 months after HSCT, and did not receive AZA (8 months representing the median disease free survival (DFS) for AZA-treated patients). The control group included all patients that relapsed ≥ 8 months after allogeneic HSCT using myeloablative busulfan 130 mg/m2 and fludarabine 40 mg/m2 for 4 days. AZA was studied as a time dependent variable. AZA and controls had similar baseline characteristics as described in the Table, although median DFS after the first HSCT was 8 (range: 2–51) and 17 (range: 7–59) months, favoring the control group (p=0.08). AZA was administered outpatient, with good tolerance. Fatigue and nausea were commonly observed toxicities. Doses were 8 mg/m2 (n=1), 16 mg/m2 (n=3), 24 mg/m2 (n=10), 32 mg/m2 (n=5), 40 mg/m2 (n=2), and 75 mg/m2 (n=2), administered subcutaneously for 5 days, in 28–32-day cycles. Results: Median number of cycles was 4 (range, 1–44). With a median follow-up of 18 months for AZA and control patients, median survival after relapse was 17 versus 6 months, respectively for AZA and control patients. 11 (48%) AZA patients are alive, while 2 (11%) control patients are alive. Two-year overall survival (OS) for AZA and control groups was 40% and 10%, respectively. AZA and controls had similar baseline characteristics as described in the Table. Conclusion: Low-dose AZA was a well tolerated outpatient treatment that may improve survival after AML/MDS recurrence in selected cases. Major determinants of survival in this setting, however, were remission duration after HSCT, and use of a 2nd HSCT. Disclosures: No relevant conflicts of interest to declare.

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
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