Comparison of anatomical polyester mesh without fixation and conventional flat mesh with fixation in laparoscopic total extraperitoneal repair for inguinal hernia.
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引用次数: 0
Abstract
Purpose: Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-established technique. In Taiwan, the National Health Insurance (NHI) covers the fees of the procedure and conventional mesh (polypropylene mesh), whereas the anatomical polyester mesh (Parietex™) requires additional self-pay. This study aimed to compare the outcomes of the conventional mesh with fixation versus the polyester mesh (without fixation) in laparoscopic TEP repair.
Methods: We retrospectively reviewed the medical records of male patients who underwent laparoscopic TEP repair between 2017 and 2021. Patients could choose between the conventional mesh with fixation (conventional mesh group) or self-paid Parietex™ mesh without fixation (anatomical polyester mesh group). The outcomes included operation (OP) time, prolonged length of stay (LOS), and postoperative complications.
Results: A total of 74 patients with 123 hernias were included, of which 36 patients (67 hernias) underwent the anatomical mesh without fixation, while 38 patients (56 hernias) underwent the conventional mesh with fixation. The mean OP time was 102.6 ± 45.6 and 88.5 ± 42.0 min in the conventional and the anatomical polyester mesh group. After adjusting for body mass index, diabetes mellitus, cardiovascular disease, and hernia type, no significant differences were observed between the two groups in OP time (p = 0.152) and the risk of acute pain (p = 0.337), chronic pain (p = 0.816), seroma (p = 0.941), hydrocele (p = 0.423), or hematoma (p = 0.347).
Conclusions: The conventional mesh demonstrates non-inferior outcomes compared to the anatomical polyester mesh. Given that the anatomical polyester mesh is not reimbursed by Taiwan's National Health Insurance (NHI), the use of the conventional mesh with fixation in TEP inguinal hernia repair may be a more cost-effective option in Taiwan.
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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