Hernia最新文献

{"title":"The role of serum levels of matrix metalloproteinases and their inhibitors in the etiology of inguinal hernia.","authors":"Hasan Basoglu, Fatih Yanar, Berke Sengun, Ibrahim Fethi Azamat, Hakan Yanar, Elif Ozkok","doi":"10.1007/s10029-025-03477-7","DOIUrl":"https://doi.org/10.1007/s10029-025-03477-7","url":null,"abstract":"<p><strong>Aim: </strong>Inguinal hernias are one of the most common operations performed worldwide, but etiopathogenesis remains important in current practice. Recent studies have frequently examined factors affecting the extracellular matrix and collagens and their association with hernias. This study aimed to investigate the role of matrix metalloproteinases (MMPs) and their inhibitors in the etiopathogenesis of inguinal hernia.</p><p><strong>Methods: </strong>Serum samples obtained from 90 male inguinal hernia patients and 70 male control patients who presented to our clinic between March 15, 2024, and September 30, 2024, were analyzed using the ELISA method. Serum levels of matrix metalloproteinases (MMP-1, MMP-8, MMP-13) and tissue inhibitors of metalloproteinases (TIMP-1, TIMP-2) were measured. The serum level results were compared in terms of net MMP activity, which was determined by calculating the MMP/TIMP ratios.</p><p><strong>Results: </strong>The serum level of MMP-1 was found to be significantly higher in the hernia group (9.1 vs. 7.5; p < 0.001). No significant differences were observed in the levels of other enzymes. In terms of net MMP activity, the ratios of MMP-1/TIMP-1 (hernia: 1.1 vs. control: 0.8, p = 0.01), MMP-1/TIMP-2 (hernia: 0.3 vs. control: 0.2, p < 0.001), and MMP-13/TIMP-2 (hernia: 0.14 vs. control: 0.11, p = 0.046) were higher in the hernia group, whereas the MMP-8/TIMP-1 ratio (hernia: 4.5 vs. control: 7.0, p = 0.017) was lower.</p><p><strong>Conclusion: </strong>In the inguinal hernia group, the serum level of MMP-1 and net MMP activity were increased, while the MMP-8/TIMP-1 ratio was decreased compared to the control group. These findings suggest that these markers may play a role in the etiopathogenesis of hernia.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"280"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the association between BMI classes and the outcome in incisional hernia repair?","authors":"F Köckerling, K Zarras, R Schwab, H Niebuhr, W Reinpold, H Riediger, F Mayer, B Stechemesser, J Conze, R Lorenz, R Fortelny","doi":"10.1007/s10029-025-03437-1","DOIUrl":"https://doi.org/10.1007/s10029-025-03437-1","url":null,"abstract":"<p><strong>Introduction: </strong>The percentage of people who are overweight or obese is increasing worldwide. Already today, almost three billion out of 8.2 billion people are overweight. Patients with overweight or obesity are at a higher risk of developing incisional hernias following abdominal procedures. Registry data on open ventral hernia repair reveal rates of 58.5% in the presence of obesity. There are very few studies on the outcome of incisional hernia repair in relation to BMI classes.</p><p><strong>Materials and methods: </strong>In a retrospective study of data on incisional hernias in the Herniamed Registry, multivariable analysis of potential confounding factors on the outcome was carried out. The prime focus was on the association of BMI classes, as defined by WHO.</p><p><strong>Results: </strong>Following patient selection, 42,081 patients were included in the analysis (normal weight: 22.9%; overweight: 38.5%, and obesity: 38.5%). No association was found between the outcome and the BMI classes with regard to the intraoperative complications, general complications or chronic pain requiring treatment. An unfavorable relationship was identified between higher BMI classes and the postoperative complications, complication-related reoperations and recurrences. A favorable relationship was seen between higher BMI classes and chronic pain at rest and on exertion.</p><p><strong>Conclusion: </strong>Since higher BMI classes have a very negative association with the outcome in incisional hernia repair with regard to postoperative complications, complication-related reoperations and recurrence, preoperative weight loss seems to be an important measure to avoid complications and recurrences.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"278"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Progressive Motor-Control-Based Exercise Approach for Women with Diastasis Recti Abdominis: The Denizoglu Method.","authors":"Hilal Denizoglu Kulli, Merve Bilgic, Melike Ozcelik","doi":"10.1007/s10029-025-03470-0","DOIUrl":"10.1007/s10029-025-03470-0","url":null,"abstract":"<p><strong>Purpose: </strong>This randomized controlled study investigated the effectiveness of a novel progressive motor control-based exercise program (The Denizoglu Method) on IRD, abdominal endurance, pelvic floor dysfunctions, and body image satisfaction in women with diastasis recti abdominis (DRA).</p><p><strong>Methods: </strong>This was a randomized controlled study of 50 women diagnosed with DRA within 1-3 years of the postpartum period. The progressive motor control-based exercise program and the conventional exercise program were performed 5 times a week for 8 weeks in a home-based and telerehabilitation setting. The primary outcome measured was inter-recti distance (IRD), while secondary outcomes included the static abdominal flexion endurance test, the Pelvic Floor Distress Inventory-20 (PFDI-20-20), and the Multidimensional Body-Self Relations Questionnaire (MBSRQ). All assessments were conducted both pre- and post-intervention.</p><p><strong>Results: </strong>The Denizoglu Method group demonstrated significant improvements in IRD, static abdominal flexion endurance, PFDI-20-20, and MBSRQ scores. Similarly, the conventional exercise training group exhibited statistically significant enhancements in IRD and PFDI-20-20 scores. However, the Denizoglu Method was found to be superior in improving IRD and abdominal endurance in women with DRA 1 to 3 years postpartum.</p><p><strong>Conclusions: </strong>The Denizoglu Method emerges as a promising approach for managing DRA in clinical practice. It can be effectively implemented as a supervised home-based exercise program or integrated in women's health care centers during the 1 to 3 years postpartum period.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"282"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous use of anticoagulants in inguinal hernia repair - a systematic review and meta-analysis.","authors":"Gustavo Magalhães Albuquerque, Maria Clara Morais, Denise Padilha Abs de Almeida, Raquel Nogueira, Diego Camacho, Diego L Lima","doi":"10.1007/s10029-025-03473-x","DOIUrl":"10.1007/s10029-025-03473-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The perioperative management of anticoagulation in patients undergoing inguinal hernia repair remains a critical yet debated issue, requiring careful balance between thromboembolic risk and bleeding. Despite the prevalence of patients on chronic anticoagulation-and variability in clinical guidelines-evidence-based strategies are needed to guide perioperative decision-making, ensuring both patient safety and surgical efficacy. Furthermore, more evidence is needed comparing outcomes in patients on and off anticoagulation, particularly regarding postoperative outcomes. This study aims to assess and analyse existing data on the use of anticoagulants during inguinal hernia repairs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A comprehensive online search was conducted across databases (PubMed/MEDLINE, EMBASE, ClinicalTrials.gov, and Cochrane Library) from inception until March 2025. Observational studies and clinical trials exclusively comparing continued anticoagulation vs. no anticoagulation in patients undergoing inguinal hernia repair were included, with no restrictions on language. The primary outcomes were hematoma formation, and hematoma surgical intervention. Studies involving antiplatelets or fibrinolytics were excluded. Secondary outcomes included seroma formation, surgical site infection (SSI), operative time (OT), and length of stay (LOS). Meta-analysis was performed using R software (version 5) and heterogeneity was assessed using I&lt;sup&gt;2&lt;/sup&gt; statistic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,483 studies were screened, and 33 were fully reviewed. Four observational studies with 1,384 patients were analyzed. Among these, three studies employed open repair the surgical approach. Anticoagulation was used perioperatively in 549 patients (39.7%), with a mean age of 73.4 ± 9.3 years. The most common indication for anticoagulation was atrial fibrillation (31%), followed by a history of venous thromboembolism (20.4%). Patients undergoing inguinal hernia repair while on anticoagulation had a higher risk of hematoma formation (RD 0.06; 95% CI 0.04-0.09; p = &lt; 0.00001; I² = 18%) compared to the control group. However, in two of the four studies analyzed, the anticoagulated group did not present a higher incidence of hematoma intervention versus the control group (0% vs. 0% and 0% vs. 25%). Two studies reported a higher rate of hematoma intervention in the anticoagulated group (53.6% vs. 0% and 25% vs. 0%). Operative time (61.1 ± 29.8 vs. 57.3 ± 24.4 min) and hospital length of stay (8.8 ± 5.3 vs. 2.9 ± 3.8 days) were also increased in the anticoagulated group. Nevertheless, the incidence of seroma and surgical site infection did not differ significantly between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Perioperative anticoagulation in open inguinal hernia repair was associated with a higher risk of hematoma formation, prolonged operative time, and increased length of hospital stay. In contrast, other posto","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"279"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective evaluation of a funnel-shaped mesh for the prevention of parastomal hernias in patients with permanent end colostomy.","authors":"Francesco Brucchi, Maria Rennis, Pietro Achilli, Lorenzo Morini, Pietro Carnevali, Matteo Origi, Gianlorenzo Dionigi, Giovanni Ferrari","doi":"10.1007/s10029-025-03481-x","DOIUrl":"10.1007/s10029-025-03481-x","url":null,"abstract":"<p><strong>Background: </strong>Parastomal hernia (PSH) is the most common long-term complication after abdominoperineal resection (APR) with permanent end colostomy. Although prophylactic mesh placement has been suggested to reduce the rate of PSH, the optimal mesh type and surgical technique remain unclear. Recently, three-dimensional funnel-shaped meshes have been introduced to stabilize the bowel loop and minimize stoma-related mechanical stress, potentially reducing the incidence of PSH.</p><p><strong>Methods: </strong>This retrospective cohort study, reported in accordance with STROBE guidelines, included consecutive patients who underwent elective laparoscopic permanent end colostomy (PEC) between 2011 and 2019 at a single institution. Patients were assigned to either a group without mesh or a group that received prophylactic intraperitoneal funnel-shaped mesh. The primary endpoint was radiologically confirmed PSH incidence. Kaplan-Meier analysis and Cox regression were used to assess differences in cumulative PSH risk over time.</p><p><strong>Results: </strong>Seventy-five patients were included (mesh group: 37; no-mesh group: 38), with a median follow-up of 46 and 43 months, respectively. The mesh group had a lower, but not statistically significant, absolute incidence of PSH (21.6% vs. 39.5%, p = 0.094). Importantly, the Kaplan-Meier analysis revealed a significantly lower cumulative incidence of PSH in the mesh group over time (p= 0.033). Postoperative complication rates were comparable between the groups.</p><p><strong>Conusions: </strong>Prophylactic placement of a funnel-shaped mesh during PEC was associated with a reduced cumulative incidence of PSH over long-term followup without increasing surgical morbidity. These results underline the potential benefit of funnel-shaped meshes in PSH prevention and highlight the need for prospective randomized studies.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"281"},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of incisional hernia with biosynthetic mesh at the site of temporary ileostomy closure (PRINCESS Study): Preliminary Results.","authors":"Roberto Peltrini, Carla Rognoni, Giovanni Bellanova, Marco Caricato, Massimo Carlini, Stefania Cimbanassi, Francesco Corcione, Federico Cozzani, Diego Cuccurullo, Giuseppe Faillace, Silvia Neri, Alberto Patriti, Mauro Santarelli, Vincenzo Trapani, Gabriella Teresa Capolupo, Gabriele Carbone, Desiree Cianflocca, Stefano Cioffi, Maria Michela Di Nuzzo, Davide Ferrara, Paola Antonella Greco, Biancamaria Iacone, Francesca Pecchini, Matteo Rossini, Michele Sacco, Stefano Sala, Domenico Spoletini, Salvatore Tramontano, Rosanna Tarricone, Giampiero Campanelli, Giuseppe Cavallaro, Micaela Piccoli, Giorgio Soliani, Cesare Stabilini, Umberto Bracale","doi":"10.1007/s10029-025-03462-0","DOIUrl":"10.1007/s10029-025-03462-0","url":null,"abstract":"<p><strong>Purpose: </strong>Incisional hernia after ileostomy closure is a complication that adversely affects patient outcomes, quality of life (QoL), healthcare resources, and related costs. Prophylactic mesh reinforcement, both biological and synthetic, has been shown to be safe and effective in preventing stoma site incisional hernia (SSIH). This study aimed to evaluate the use of a slowly absorbable biosynthetic mesh at the site of temporary ileostomy closure to prevent SSIH.</p><p><strong>Methods: </strong>This prospective, single-arm observational study was conducted across 14 Italian hospitals. Patients undergoing ileostomy reversal with retromuscular placement of a poly-4-hydroxybutyrate (Phasix™) mesh were enrolled. Endpoints included the incidence of radiologically and clinically detected SSIH at 1-year, postoperative morbidity, wound complications, and QoL assessed using the EuroQoL 5D-5 L and Carolinas Comfort Scale (CCS) questionnaires.</p><p><strong>Results: </strong>A total of 115 patients completed at least 1 year of follow-up and were included in the analysis. Seromas was the most frequent complication (8.6%). Superficial and deep SSIs occurred in 6% and 1.7% of patients, respectively. Three complications required intervention (2.6%), including one mesh removal. The 1-year SSIH rate was 1.7%, with a median follow-up of 477 d (range: 263-880). Considering the 55 patients (47.8%) who completed 2-year follow-up, the cumulative SSIH rate was 4.3%. EuroQoL 5D-5 L and CCS scores demonstrated progressive improvement in QoL and symptom reduction over time (p < 0.0001).</p><p><strong>Conclusion: </strong>These preliminary findings suggest that prophylactic placement of a slowly absorbable biosynthetic mesh (Phasix™) is safe and effective for SSIH prevention following ileostomy closure, without negatively impacting the patient's QoL. The use of biosynthetic meshes may be considered a valid alternative to biological or synthetic meshes in this setting.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"277"},"PeriodicalIF":2.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic versus robotic total extraperitoneal (TEP) inguinal hernia repair: a multicenter, propensity score weighted study.","authors":"Ming-Wei Li, Vincent Fang-Sheng Tsai, Tze-Chen Chao, Heng-Yu Tung, Ching-Hong Tsai, Cheng-Ming Pen, Chia-Chang Wu, Chun-Ho Liao, Yen-Chuan Ou, Cheng-Chung Tsai, Shei-Dei Yang, Yao-Chou Tsai","doi":"10.1007/s10029-025-03467-9","DOIUrl":"10.1007/s10029-025-03467-9","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this retrospective study was to assess safety and comparative clinical effectiveness of laparoscopic total extraperitoneal inguinal hernia repair (LTEP) and robot-assisted total extraperitoneal inguinal hernia repair (RaTEP) from multi-institutional experience in Taiwan.</p><p><strong>Methods: </strong>Medical records from eight hospitals in Taiwan were collected and analyzed retrospectively. Patients diagnosed of inguinal hernia, recurrent inguinal hernia and incarceration groin hernia and receiving either laparoscopic or robot-assisted TEP inguinal hernia repair between January 2018 and December 2022 were included in the study. Baseline characteristics, intra-operative and post-operative results were analyzed. To compare two cohorts, overlap Weighting was employed to balance the significant inter-group differences with a standardized mean difference less than 0.001. We also conducted subgroup analyses by state of a hernia (primary or recurrent/incarceration) and laterality (unilateral or bilateral) that indicated complexity of surgery.</p><p><strong>Results: </strong>A total of 1080 patients who underwent minimally-invasive inguinal hernia repair from 8 hospitals across Taiwan were collected. Following the application of inclusion criteria, there were 237 patients receiving RaTEP and 583 patients receiving LTEP. In the baseline analysis, RaTEP was more often performed in recurrent/incarceration (RaTEP 16.4% vs. LTEP 10.5%, p = 0.050) and bilateral cases (RaTEP 84.0% vs. LTEP 52.5%, p < 0.001). Suturing was the dominant mesh fixation method in RaTEP (RaTEP 80.2% vs. LTEP 20.4%, p < 0.001). More overweight patients were treated with RaTEP (RaTEP 59.5% vs. LTEP 50.3%, p = 0.020). After overlap weighting, there were no significant difference in intraoperative and post-operative complications between RaTEP and LTEP. Prescription rates of pain medication (opioid) were significantly lower in RaTEP than LTEP in overall group comparison (RaTEP 3.56 mg vs. LTEP 13.56 mg, p < 0.001) while operation time was significantly longer in RaTEP (RaTEP 148.83 min vs. LTEP 87.49 min, p < 0.001).</p><p><strong>Conclusions: </strong>RaTEP is safe and demonstrates surgical outcomes comparable to LTEP. It shows technical advantages in more complex hernia cases, facilitates suture fixation of the mesh, and reduces postoperative opioid use.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"276"},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of oncologic hernia repair using Poly-4-Hydroxybutyrate (P4HB) mesh.","authors":"Jacob Levy, Benjamin D Wagner, Ronnie L Shammas, Lillian A Boe, Charlotte E Ariyan, Mary S Brady, Robert J Allen, Evan Matros, Babak J Mehrara, Jonas A Nelson","doi":"10.1007/s10029-025-03468-8","DOIUrl":"https://doi.org/10.1007/s10029-025-03468-8","url":null,"abstract":"<p><strong>Introduction: </strong>Hernia repair following cancer surgery is often challenging due to prior radiation therapy, malnutrition, and immunosuppression. Poly-4-hydroxybutyrate (P4HB) is a biosynthetic mesh that balances strength and biocompatibility, potentially optimizing outcomes in this high-risk population. This study aimed to evaluate recurrence and surgical site complications associated with P4HB mesh in oncologic patients undergoing incisional hernia repair and to identify surgical techniques related to improved outcomes.</p><p><strong>Methods: </strong>Patients with previous oncologic abdominal or pelvic surgery who developed an incisional hernia and underwent surgical repair using P4HB from January 2018 to December 2023 were identified. Patients were analyzed according to wound classification. Primary outcomes included hernia recurrence and surgical site complications (hematoma, infection/cellulitis, superficial wound dehiscence, and abscess formation).</p><p><strong>Results: </strong>102 patients [median (IQR) age 63 (55-69) years; median BMI 26 (23-30) kg/m²] were included, with a median follow-up of 26.1 (15.1-40.1) months. The overall recurrence rate was 8.8%, significantly differing between clean (Class I) and contaminated (Class II-IV) cases (0% vs. 17%, p = 0.003). Surgical complications occurred in 24% of patients, with seroma (8.8%) and superficial wound dehiscence (7.8%) being the most common, and complication rates comparable between wound classifications. Bilateral external oblique release (HR, 0.16; 95% CI, 0.04-0.65; p = 0.01) and retrorectus mesh placement (HR, 0.05; 95% CI, 0.01-0.36; p = 0.004) were independently associated with reduced recurrence.</p><p><strong>Conclusion: </strong>P4HB mesh in incisional hernia repair for oncologic patients yields low recurrence rates and acceptable complication rates. Bilateral external oblique release and retrorectus mesh placement are surgical techniques significantly associated with improved outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"274"},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic groin pain after Lichtenstein inguinal hernia repair: partially absorbable light-weight mesh versus conventional light-weight versus heavy-weight mesh.","authors":"Sarah Budney, Kyle Kleppe, Matthew Mancini, Greg Mancini, Melissa Phillips, Catherine McKnight, John Griepentrog, Michael Reinhorn, Aldo Fafaj, Kaela E Blake","doi":"10.1007/s10029-025-03469-7","DOIUrl":"10.1007/s10029-025-03469-7","url":null,"abstract":"<p><strong>Introduction: </strong>Mesh properties are important contributing factors to chronic postoperative inguinal pain (CPIP) following Lichtenstein inguinal hernia repair. Some studies show using a light-weight mesh (LWM, <50 g/m2) over heavy-weight mesh (HWM, >70 g/m2) may decrease CPIP. However, most studies do not distinguish between partially absorbable light-weight mesh (PA-LWM) and permanent LWM. This study compares the rates of CPIP between PA-LWM, LWM, and HWM after Lichtenstein inguinal hernia repair.</p><p><strong>Methods: </strong>A retrospective analysis of the ACHQC database from 2014 to 2024 was conducted for elective Lichtenstein repair of non-recurrent, unilateral inguinal hernias. Mesh was categorized as LWM <50 g/m2 or HWM ≥70 g/m2 distinguishing partially absorbable LWM. The primary outcome was the rate of CPIP at 6 months postoperatively for PA-LWM, LWM, and HWM.</p><p><strong>Results: </strong>319 patients met criteria for the study with 53 PA-LWM, 122 LWM, and 144 HWM patients. Baseline pain was highest in PA-LWM and lowest in HWM cohorts. At 6 months, 21% of PA-LWM, 21% of LWM, and 19% of HWM patients had chronic pain (p=0.93). This decreased to 3% for PA-LWM at 1-year, but remained approximately 20% for LWM and HWM (p = 0.045). The clinical recurrence rate at 1-year was 50% (2/4), 0% (0/8), and 0% (0/17) for PA-LWM, LWM, and HWM respectively (p = 0.001).</p><p><strong>Conclusion: </strong>This study found that roughly 20% of patients have chronic pain at 6 months regardless of mesh weight or partially absorbable properties. While PA-LWM may decrease CPIP at 1 year, this may be accompanied with a higher clinical recurrence rate.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"275"},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the preferred mesh placement in primary ventral hernia repair? An international survey of 442 surgeons.","authors":"Usamah Ahmed, Jacob Rosenberg, Sarfaraz Jalil Baig, Sujith Wijerathne, Wah Yang, Shuqing Li, Jason Joe Baker","doi":"10.1007/s10029-025-03429-1","DOIUrl":"10.1007/s10029-025-03429-1","url":null,"abstract":"<p><strong>Purpose: </strong>Primary ventral hernia repair is a common elective procedure; however, mesh placement practices vary widely, and there is limited evidence to guide optimal placement. This international study examined surgeons' preferences and considerations regarding mesh placement in elective primary ventral hernia repair.</p><p><strong>Methods: </strong>We conducted an international cross-sectional survey targeting surgeons experienced in primary ventral hernia repair. The survey was distributed through hernia societies and social media platforms. It included 31 questions addressing surgeon demographics and their beliefs on various mesh placements. Data were collected using REDCap, Google Forms, and Questionstar.</p><p><strong>Results: </strong>A total of 442 surgeons participated, with the majority being specialist surgeons (96%) who had performed at least 100 repairs (82%). Inlay was the least familiar mesh technique (26%). For hernia defects < 1 cm, preperitoneal (28%) and suture-only repair (27%) were considered to yield the best overall outcomes. For defects ≥ 1 to ≤ 4 cm, preperitoneal and retromuscular techniques were equally favored (34%), whereas retromuscular was regarded as the best option for larger defects (> 4 to 9 cm; 68%). Laparoscopic and robotic-assisted approaches were increasingly preferred for larger defect sizes. Hernia defect size (93%), surgical history (90%), and obesity (80%) were the most common factors influencing the choice of mesh placement.</p><p><strong>Conclusion: </strong>Preperitoneal and suture-only repairs were most commonly selected for hernia defects < 1 cm, while preperitoneal and retromuscular placements were equally favored for defects ≥ 1 to ≤ 4 cm. For defects > 4 to 9 cm, retromuscular placement was selected by most surgeons. As defect width increased, laparoscopic and robot-assisted approaches gained preference. Key factors influencing decisions included hernia defect size, surgical history, and obesity. The lack of strong supporting evidence highlights the need for further high-quality research.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"273"},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}