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Comparable results with 3-year follow-up for large-pore versus small-pore meshes in open incisional hernia repair

(2010) SURGERY. 148(5). p.969-975
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Organization
Abstract
Background. Decreasing the amount of polypropylene by increasing pore size produces a lighter weight mesh that may improve tissue ingrowth and, functional properties of the abdominal wall and diminish mesh-related complications. It was the aim of this prospective observational cohort study to analyze the outcome of incisional hernia repair using small-pore versus large-pore meshes and using a standardized, open, retromuscular surgical technique. Methods. Across a 6-year period we analyzed 205 patients treated with a heavyweight mesh (group I) and 235 patients treated with a large-pore mesh (group II) for incisional hernias. Patients with a body mass index greater than 40 kg/m(2) and patients with hernias with a transverse diameter of more than 10 cm were not treated by a retromuscular mesh repair and are not included in this analysis. Recurrent incisional hernias also were not included. Both groups had 3 years of follow-up. Patients were evaluated for pain, discomfort, feeling of foreign material, and recurrences. Results. Pre-operative characteristics were comparable between the groups, including body mass index, diabetes, and smoking. The mean total hernia surface was 56 cm(2) for group I versus 48 cm(2) in group II. The mesh surface area was 448 cm(2) for group I and 425 cm(2) for group II. Considering pain scores, there was only a minor difference between the 2 groups at 1-month follow-up, at which time, the Visual Analogue Scale was 5.8 in group land 4.9 in group II (P = .16). All other scores were comparable between the groups. In group I, 7 recurrences (3.4%) were recorded after 3 years, of which 6 were already apparent 1 year after initial repair. In group II, 9 recurrences (3.8%) were diagnosed, again 6 within the first year after repair. Conclusion. Large-pore meshes can be used safely for open primary incisional hernia repair with an equal outcome compared with small-pore meshes in nonobese patients with defects smaller than 10 cm in width, in regard to both recurrence rates and chronic discomfort.
Keywords
POLYPROPYLENE MESH, INGUINAL-HERNIA, LIGHTWEIGHT COMPOSITE MESH, RANDOMIZED CLINICAL-TRIAL, OUTCOMES, COMPLICATIONS, SUTURE, MODEL, RISK

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Chicago
Berrevoet, Frederik, LEANDER MAES, Luc De Baerdemaeker, Xavier Rogiers, Roberto Troisi, and Bernard de Hemptinne. 2010. “Comparable Results with 3-year Follow-up for Large-pore Versus Small-pore Meshes in Open Incisional Hernia Repair.” Surgery 148 (5): 969–975.
APA
Berrevoet, F., MAES, L., De Baerdemaeker, L., Rogiers, X., Troisi, R., & de Hemptinne, B. (2010). Comparable results with 3-year follow-up for large-pore versus small-pore meshes in open incisional hernia repair. SURGERY, 148(5), 969–975.
Vancouver
1.
Berrevoet F, MAES L, De Baerdemaeker L, Rogiers X, Troisi R, de Hemptinne B. Comparable results with 3-year follow-up for large-pore versus small-pore meshes in open incisional hernia repair. SURGERY. 2010;148(5):969–75.
MLA
Berrevoet, Frederik, LEANDER MAES, Luc De Baerdemaeker, et al. “Comparable Results with 3-year Follow-up for Large-pore Versus Small-pore Meshes in Open Incisional Hernia Repair.” SURGERY 148.5 (2010): 969–975. Print.
@article{1200513,
  abstract     = {Background. Decreasing the amount of polypropylene by increasing pore size produces a lighter weight mesh that may improve tissue ingrowth and, functional properties of the abdominal wall and diminish mesh-related complications. It was the aim of this prospective observational cohort study to analyze the outcome of incisional hernia repair using small-pore versus large-pore meshes and using a standardized, open, retromuscular surgical technique.
Methods. Across a 6-year period we analyzed 205 patients treated with a heavyweight mesh (group I) and 235 patients treated with a large-pore mesh (group II) for incisional hernias. Patients with a body mass index greater than 40 kg/m(2) and patients with hernias with a transverse diameter of more than 10 cm were not treated by a retromuscular mesh repair and are not included in this analysis. Recurrent incisional hernias also were not included. Both groups had 3 years of follow-up. Patients were evaluated for pain, discomfort, feeling of foreign material, and recurrences.
Results. Pre-operative characteristics were comparable between the groups, including body mass index, diabetes, and smoking. The mean total hernia surface was 56 cm(2) for group I versus 48 cm(2) in group II. The mesh surface area was 448 cm(2) for group I and 425 cm(2) for group II. Considering pain scores, there was only a minor difference between the 2 groups at 1-month follow-up, at which time, the Visual Analogue Scale was 5.8 in group land 4.9 in group II (P = .16). All other scores were comparable between the groups. In group I, 7 recurrences (3.4\%) were recorded after 3 years, of which 6 were already apparent 1 year after initial repair. In group II, 9 recurrences (3.8\%) were diagnosed, again 6 within the first year after repair.
Conclusion. Large-pore meshes can be used safely for open primary incisional hernia repair with an equal outcome compared with small-pore meshes in nonobese patients with defects smaller than 10 cm in width, in regard to both recurrence rates and chronic discomfort.},
  author       = {Berrevoet, Frederik and MAES, LEANDER and De Baerdemaeker, Luc and Rogiers, Xavier and Troisi, Roberto and de Hemptinne, Bernard},
  issn         = {0039-6060},
  journal      = {SURGERY},
  keyword      = {POLYPROPYLENE MESH,INGUINAL-HERNIA,LIGHTWEIGHT COMPOSITE MESH,RANDOMIZED CLINICAL-TRIAL,OUTCOMES,COMPLICATIONS,SUTURE,MODEL,RISK},
  language     = {eng},
  number       = {5},
  pages        = {969--975},
  title        = {Comparable results with 3-year follow-up for large-pore versus small-pore meshes in open incisional hernia repair},
  url          = {http://dx.doi.org/10.1016/j.surg.2010.02.011},
  volume       = {148},
  year         = {2010},
}

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