F Köckerling, J Wrede, D Adolf, D Jacob, H Riediger
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引用次数: 0
Abstract
Introduction: In inguinal hernia repair, mesh weight and pore size are used to describe the mesh characteristics. One meta-analysis of laparo-endoscopic inguinal hernia repairs identified 12 prospective randomized controlled trials (RCTs) with 2,909 patients who had all been treated with lightweight (≤ 50 g/m²) or heavyweight (> 70 g/m²) meshes. None of the 12 RCTs gave details of the pore size. There were more recurrences when using lightweight meshes, in particular in the case of medial defects without mesh fixation and/or large defects. In terms of pain, no significant differences were seen. This retrospective analysis of data from the Herniamed Registry now aims to analyze whether mesh pore size is related to the outcome in laparo-endoscopic inguinal repair.
Materials and methods: To analyze the association between mesh pore size and the outcome in laparo-endoscopic inguinal repair, it was necessary to select meshes with comparable properties. Polyester meshes and PTFE meshes had to be excluded and polypropylene and polyvinylidene fluoride meshes (PVDF) were included. 83,768 included patients were retrospectively analyzed. The meshes analyzed were eight small-pore and 13 large-pore meshes. Using a binary logistic regression model, it is possible to simultaneously analyze several factors being potentially associated with the outcome.
Results: Higher BMI, lower weight meshes, higher ASA score and medial EHS classification were associated with a higher risk of recurrence. It was not possible to find any significant association between pore size and recurrences at one-year follow-up. This also applied for pain on exertion and pain requiring treatment.
Conclusion: No association was identified between the pore size of the meshes used in laparo-endoscopic inguinal repair and the recurrence rate, pain on exertion rate or the rate of chronic pain requiring treatment at one-year follow-up.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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