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

Frederik Berrevoet UGent, LEANDER MAES UGent, Luc De Baerdemaeker UGent, Xavier Rogiers UGent, Roberto Troisi UGent and Bernard de Hemptinne UGent (2010) SURGERY. 148(5). p.969-975
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
POLYPROPYLENE MESH, INGUINAL-HERNIA, LIGHTWEIGHT COMPOSITE MESH, RANDOMIZED CLINICAL-TRIAL, OUTCOMES, COMPLICATIONS, SUTURE, MODEL, RISK
journal title
SURGERY
Surgery
volume
148
issue
5
pages
969 - 975
Web of Science type
Article
Web of Science id
000283888000010
JCR category
SURGERY
JCR impact factor
3.406 (2010)
JCR rank
16/186 (2010)
JCR quartile
1 (2010)
ISSN
0039-6060
DOI
10.1016/j.surg.2010.02.011
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1200513
handle
http://hdl.handle.net/1854/LU-1200513
date created
2011-03-31 13:36:55
date last changed
2011-04-01 10:09:42
@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},
}

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.