Hernia最新文献

{"title":"Systematic review and meta-analysis on robotic assisted ventral hernia repair: the ROVER review.","authors":"Sara Capoccia Giovannini, Maaike Vierstraete, M Frascio, G Camerini, F Muysoms, C Stabilini","doi":"10.1007/s10029-025-03274-2","DOIUrl":"https://doi.org/10.1007/s10029-025-03274-2","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic surgery for ventral hernia repair (VHR) is gaining attention for its potential advantages over laparoscopic and open techniques. This approach combines the advantages of minimally invasive surgery with the ability to perform technically challenging procedures, often required in open surgery but difficult with conventional laparoscopy. We aim to evaluate the efficacy and safety of robotic VHR compared to other surgical approaches, focusing on postoperative complications, operative time, and costs.</p><p><strong>Material and methods: </strong>A systematic review with meta-analysis were conducted, including 67 studies from January 2010 to May 2023 on Robotic VHR compared with other techniques. Primary outcome was 30-days postoperative complications; SSI, SSO, seroma, mortality, recurrence, length of hospital stay, operative time and costs were analysed as secondary outcomes.</p><p><strong>Results: </strong>Robotic surgery was associated with longer operative times compared to both laparoscopic (MD 64.67 min; p < 0.001) and open repairs (MD 69.69 min; p < 0.001). However, it resulted, compared to open surgery, in fewer SSIs (OR 0.62; p 0.05), mortality (OR 0.44; p 0.04) and shorter hospital stay (MD -3.77 days; p < 0.001). No differences were found in overall complications or length of stay between robotic and laparoscopic approaches but higher costs and longer operative times were reported in robotic VHR.</p><p><strong>Conclusions: </strong>Based on the currently available low-quality evidence, robotic VHR appears to offer limited advantages compared to laparoscopic techniques. However, when compared to open approaches, robotic VHR may demonstrate reduced postoperative complications and shorter hospital stays even if an higher rate of seroma formation was retrieved probably related to technical details. Nevertheless, longer operative times and higher costs remain significant limitations. Further high-quality comparative studies are warranted to assess long-term outcomes and cost-effectiveness.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"95"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448654","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":"Preoperative Botulinum Toxin A (BTA) injection in abdominal wall reconstruction for subxiphoid (M1) hernias.","authors":"Monica E Polcz, Alexis M Holland, William R Lorenz, Sullivan Ayuso, Gregory T Scarola, Dau Ku, Vedra A Augenstein, B Todd Heniford","doi":"10.1007/s10029-025-03290-2","DOIUrl":"https://doi.org/10.1007/s10029-025-03290-2","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative BTA assists with fascial closure during abdominal wall reconstruction. Its efficacy in subxiphoid (M1) hernias has been questioned with high rates of component separation techniques (CST) despite BTA. To assess the role of BTA in these hernias, we compared fascial closure and recurrence rates in patients with M1 hernias requiring CST with or without preoperative BTA.</p><p><strong>Methods: </strong>A prospectively maintained database at a tertiary hernia center was reviewed for M1 hernias who underwent CST, and grouped based on use of preoperative BTA. Standard univariate analysis was performed.</p><p><strong>Results: </strong>Of 67 patients, 30 (44.8%) received preoperative BTA. BTA versus non-BTA groups had similar mean ages (56.0 ± 14.1vs.61.5 ± 11.8 years, p = 0.087), ASA score (p = 0.345), rate of diabetes (p = 0.421), and very large defect size (499.2 ± 185.5vs.416.1 ± 238.6 cm2,p = 0.144). In the BTA group, BMI was lower (28.9 ± 5.1vs.32.7 ± 7.2 kg/m2,p = 0.018), with fewer current smokers (0%vs.10.8%,p = 0.006), and more contaminated (20.0%vs.5.4%) and dirty cases (33.3%vs.13.5%) (p = 0.008). External oblique release was performed in 24 (80.0%) BTA patients versus 23 (62.2%) non-BTA (p = 0.179), posterior CST in 6 (20.0%) versus 14 (37.8%) (p = 0.133). Rates of bilateral CST (90.0%vs.94.6% p = 0.394), fascial closure (90.0%vs.94.6%,p = 0.650), overall wound complications (33.3%vs.43.2%,p = 0.458), and recurrence (6.7%vs.2.7%,p = 0.583) were similar with average follow up of 12.7 ± 18.8 versus 24.1 ± 28.2 months (p = 0.062).</p><p><strong>Conclusion: </strong>Repair of very large M1 hernias requires high rates of CST despite preoperative BTA injection. When CST is needed, BTA as a preoperative adjunct does not appear to offer benefit in terms of fascial closure rates, frequency of bilateral CST, or risk of recurrence.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"96"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448233","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":"Postoperative outcomes and wound events in incisional hernia repair using hybrid mesh: results from a prospective multicenter italian study.","authors":"Francesco Pizza, Antonio Iuppa, Pietro Maida, Vincenzo Pilone, Antonio Crucitti, Tomaiuolo Pasquina Maria Carmen, Lorenzo Morini, Jacopo Nicoló Marin, Tommaso Petitti, Camillo Bertoglio, Gianpaolo Marte, Ignazio Sordelli, Simona Gili, Francesco Saverio Lucido, Lugi Busciano, Dario D'Antonio, Ludovico Docimo, Claudio Gambardella","doi":"10.1007/s10029-025-03285-z","DOIUrl":"https://doi.org/10.1007/s10029-025-03285-z","url":null,"abstract":"<p><strong>Purpose: </strong>The complexity of managing ventral hernias leads surgeons to explore different optimal techniques and mesh selection. Hybrid meshes, combining absorbable and permanent components, aim to balance long-term durability and infection risk. This study evaluated the extended-term outcomes of GORE^® SYNECOR intraperitoneal (IP) biomaterial for incisional hernia repair through minimally invasive laparoscopic techniques.</p><p><strong>Methods: </strong>Conducted across eight Italian surgery centers from January 2020 to September 2022, this multicenter analysis prospectively assessed the outcomes of patients undergoing laparoscopic repair of incisional hernias using GORE® SYNECOR. Outcomes included postoperative wound events, pain, recurrence, and mesh bulging.</p><p><strong>Results: </strong>A total of 371 patients participated in the study. No serious adverse events or significant mesh-related complications were observed. Surgical site occurrences (SSO) were recorded in a proportion of cases, and hernia sac volume was identified as the only independent risk factor (p < 0.0001). At three months post-surgery, pain levels and impacts on daily activities were minimal. At 24 months, recurrence and mesh bulging were associated only with patients with hernia sac sizes larger than 450 cm³.</p><p><strong>Conclusion: </strong>Laparoscopic incisional hernia repair using GORE^® SYNECOR hybrid mesh demonstrated satisfactory safety and efficacy regarding wound-related events and recurrence. Minor complications were more closely related to hernia sac size rather than the surgical approach, suggesting that the laparoscopic technique may optimize outcomes, particularly in elderly, smokers, and overweight patients.</p><p><strong>Clinicaltrials: </strong>NCT06166069.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"94"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447630","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":"Does sarcopenia have a negative impact on the efficacy of botulinum toxin A in the prehabilitation of patients undergoing incisional hernia repair? A multicentric retrospective study.","authors":"Aurélien Villemin, Théophile Delorme, Pablo Ortega-Deballon, Hessa Alsuwaidan, David Moszkowicz, Benoit Romain","doi":"10.1007/s10029-025-03291-1","DOIUrl":"https://doi.org/10.1007/s10029-025-03291-1","url":null,"abstract":"<p><strong>Background: </strong>Botulinum toxin A (BTA) injections are increasingly used to prepare patients undergoing surgery for incisional hernias larger than 10 cm. The aim of this study was to analyze the impact of sarcopenia on the efficacy of BTA injection in lengthening the lateral abdominal muscles.</p><p><strong>Methods: </strong>Between August 2018 and January 2024, patients with midline incisional hernias ≥ 10 cm undergoing preoperative BTA injections were included in a multicentric database. Sarcopenia was evaluated calculating the muscle area measured on a transverse CT scan at the level of the L3 lumbar vertebra. Muscle characteristics and the volumes of the incisional hernia and abdominal cavity were compared before and 4 to 6 weeks after BTA injection. The effect of BTA on muscle elongation was evaluated according to sarcopenia.</p><p><strong>Results: </strong>Fifty-nine patients were included. Sarcopenia did not impair the efficacy of BTA in terms of length of the lateral abdominal wall muscles, with a 1.8 cm increase bilaterally in each group. Regarding the efficacy of BTA injection, 80% of patients experienced elongation of the lateral abdominal wall muscles. Failure of the injection therefore affected 20% of patients. These results were similar in both groups, regardless of sarcopenia. Analysis of the characteristics of 'responders' and 'nonresponders' revealed that 'nonresponders' had a greater length of the lateral abdominal wall muscles on the scan prior to BTA injection, likely due to less significant muscle retraction.</p><p><strong>Conclusion: </strong>Sarcopenia did not impair the effectiveness of BTA in terms of elongation prior to incisional hernia repair.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"104"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448866","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":"Penetrating fixation device versus fibrin sealant for mesh fixation in laparoscopic repair of ventral hernia: a randomized controlled trial.","authors":"Hemanga Kumar Bhattacharjee, Vishal Anand, Mithun Nk, Ashwani Kumar Mishra, Aditya Baksi, Mohit Joshi, Suhani, Rajinder Parshad","doi":"10.1007/s10029-025-03294-y","DOIUrl":"https://doi.org/10.1007/s10029-025-03294-y","url":null,"abstract":"<p><strong>Purpose: </strong>Post-operative pain following intra peritoneal onlay mesh (IPOM) repair of ventral hernia is commonly attributed to mechanical fixation devices. Fibrin sealant is a novel technique of mesh fixation purported to cause less pain. The aim of this study was to compare postoperative pain in these two methods of mesh fixation.</p><p><strong>Methods: </strong>This was a double-blinded, randomized controlled trial. Eighty patients with primary ventral hernia underwent laparoscopic IPOM repair using PROCEED™ mesh, which was fixed with either mechanical fixation device, SECURESTRAP™ (MF group) or fibrin sealant, TISSEEL™ (FS group). Primary end point was postoperative pain at rest and movement on a Visual Analogue Scale (VAS) of 0-10. Operative time, recurrence, seroma and quality of life (QoL) were secondary outcomes. Patients were followed up for one year.</p><p><strong>Results: </strong>There was no significant difference in pain score at 12 h, 24 h, 7 days, 1, 3 and 12 months between the groups, except pain on movement, which was significantly less in the FS group on the seventh day (median VAS 3 vs. 2, p = 0.01). Mean operative time was 8 min longer in the FS group (p = 0.001). Two patients in the FS and none in the MF group had recurrence at one year (p = 0.18). Seroma formation, postoperative QoL and patient satisfaction scores were similar in both groups.</p><p><strong>Conclusions: </strong>Use of fibrin sealant for mesh fixation does not provide significant advantage over mechanical fixation in laparoscopic IPOM repair.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"98"},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448983","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":"Transabdominal Preperitoneal (TAPP) versus intraperitoneal onlay Mesh (IPOM) for ventral hernia repair - an updated systematic review and meta-analysis.","authors":"Ana Caroline D Rasador, Carlos A Balthazar da Silveira, Conrad Ballecer, Sergio Mazzola Poli de Figueiredo","doi":"10.1007/s10029-025-03271-5","DOIUrl":"https://doi.org/10.1007/s10029-025-03271-5","url":null,"abstract":"<p><strong>Background: </strong>Persistent controversy exists regarding the optimal approach for ventral hernia repair (VHR). Considering the concerns regarding the use of intraperitoneal mesh and the increasing use of robotic technology, transabdominal preperitoneal (TAPP) is increasingly being performed. This study aims to compare TAPP and intraperitoneal onlay mesh (IPOM) for VHR.</p><p><strong>Methods: </strong>PubMED, Cochrane, and EMBASE databases were systematically searched from inception to April 2024, for studies on patients undergoing VHR, comparing TAPP and IPOM. Outcomes included were intraoperative complications, such as vascular and bowel injury, and postoperative complications (hernia recurrence within 1 year of operation, seroma, hematoma, ileus, urinary retention, small bowel obstruction). Additional outcomes were hospital length of stay (LOS), operative time, and visual analog scale (VAS) scores after 24 h of surgery.</p><p><strong>Results: </strong>From 398 records, 8 were included in our pooled analysis, which comprised 7 retrospective cohorts and 1 prospective cohort, totaling 952 patients. 458 (48%) patients underwent laparoscopic VHR and 494 (52%) underwent robotic VHR. Our meta-analysis revealed that TAPP is associated with a lower incidence of overall postoperative complications as a composite outcome (13.9% vs 23.9%; RR 0.66; 95% CI 0.48, 0.92; P = 0.013). After performing a subgroup analysis for robotic surgeries only, we found that TAPP also has a lower rate of urinary retention (RR 0.12; 95% CI 0.02, 0.99; P = 0.049) and hematoma compared to IPOM (RR 0.20; 95% CI 0.04, 0.95; P = 0.043). No differences were seen between both techniques regarding ileus, hernia recurrence, operative time, seroma, small bowel obstruction, vascular injury, and bowel injury. Subgroup analysis for robotic VHR showed similar results. After performing a leave-one-out sensitivity analysis, we also obtained a shorter hospital LOS (MD  - 0.56 days; 95% CI  - 0.86,  - 0.25; p < 0.05) and VAS scores within 24 h of surgery (MD  - 1.04; 95% CI  - 1.61,  - 0.47; p < 0.05) for the TAPP technique.</p><p><strong>Conclusions: </strong>IPOM is associated with a higher incidence of hematoma, urinary retention, overall early postoperative complications, and potentially longer hospital LOS and higher VAS pain scores within 24 h compared to TAPP. Therefore, the TAPP should be the technique of choice for minimally invasive VHR when feasible; however, considering the availability of resources and surgeon expertise, IPOM might still be considered a viable alternative.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"93"},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424490","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":"Management of post-traumatic non-iatrogenic lumbar/flank hernias: diagnosis and treatment options-systematic review, meta-analysis and management algorithm.","authors":"Abdulaziz Elemosho, Jeffrey E Janis","doi":"10.1007/s10029-025-03281-3","DOIUrl":"10.1007/s10029-025-03281-3","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic non-iatrogenic lumbar/flank hernias (LFH) represent a unique and important subset of abdominal wall hernias that can develop following either blunt or penetrating trauma to the abdomen. There is paucity of evidence guiding the management and identification of associated complications of this hernia type in the literature. We aim to pool available cases in the literature and summarize the diagnostic and management approaches of traumatic LFH.</p><p><strong>Methods: </strong>PUBMED, EMBASE and Scopus databases were queried, and relevant articles were selected following PRISMA guideline for systematic reviews. Studies in English and with complete data on post-traumatic non-iatrogenic LFH, including case reports, were included.</p><p><strong>Results: </strong>A total of 211 cases of post-traumatic non-iatrogenic lumbar/flank hernias (LFH) from 62 articles published between 1993 and 2023 were included, with mean age of 52.1 years (interquartile range IQR: 25.8-62.7 years). Most patients had CT-confirmed diagnosis (96.1%), had inferiorly located LFHs (86.8%), and fell into Type B Moreno-Egea class (74.6%). Flank pain was the commonest presenting complaint (13.4%) with flank hematoma present at presentation in 8.6% of the cohort. Post-traumatic non-iatrogenic LFHs were diagnosed at index hospitalization/presentation in 75.5% and repaired during the same admission in 48.2% of patients. Open repair with mesh was the most common method of repair (59.8%), followed by open repair without mesh in 28.7% and by minimally invasive laparoscopic approach in 11.5% cases. Overall recurrence rate (for all repair types) was 8% at mean follow up of 15.4 months (IQR: 12.5-25.0 months). Hernia defect size of ≥ 8 cm was 100% sensitive and 52.9% specific for the prediction of mesenteric injuries. Flank hematoma/seatbelt sign was 100% sensitive and 81.8% specific for the prediction of mesenteric injuries in traumatic LFHs.</p><p><strong>Conclusions: </strong>Patients presenting with flank pain and flank hematoma following a blunt abdominal wall trauma should receive a thorough radiologic evaluation, particularly a CT scan, for post-traumatic non-iatrogenic LFHs. Complications such as mesenteric avulsion must be considered with high suspicion in patients whose hernia is associated with flank hematoma or with hernia diameter ≥ 8 cm. Long term follow-up after repair still requires further study. Open repair with extraperitoneal mesh reinforcement is the standard of care for hernias ≥ 8 cm repaired acutely or electively, and minimally invasive laparoscopic approach is typically utilized for hernias < 8 cm.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"92"},"PeriodicalIF":2.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412940","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":"Trends and cross-country inequalities in the global burden of inguinal, femoral, and abdominal hernia from 1990 to 2021, with projections from 2022 to 2035: a cross-sectional study.","authors":"Xiaoli Liu, Bangzhen Ma, Qiuyue Ma, Fan Wang, Yingmo Shen","doi":"10.1007/s10029-025-03282-2","DOIUrl":"10.1007/s10029-025-03282-2","url":null,"abstract":"<p><strong>Background: </strong>The global burden of inguinal, femoral, and abdominal hernias remains significant, particularly in low- and middle-income countries, despite medical advancements. This study aims to examine trends and cross-country inequalities in the burden of these hernias from 1990 to 2021 and project future trends to 2035.</p><p><strong>Methods: </strong>Utilizing Global Burden of Diseases (GBD) 2021 data, we analyzed prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries and territories. Development levels were quantified using the sociodemographic index (SDI). Analyses included descriptive statistics, joinpoint regression, Spearman correlation, frontier analysis, and a Bayesian age-period-cohort model for forecasting.</p><p><strong>Results: </strong>From 1990 to 2021, global prevalence increased from 13.7 million to 16.4 million, while the age-standardized rate (ASR) decreased by 24.74%. Incident cases rose from 5.8 million to 7.2 million, with a 16% decline in ASR. Deaths increased from 42,118 to 48,012, but ASR fell by 45.16%. DALYs decreased from 2.6 million to 2.3 million, with a 42.31% drop in ASR. Projections to 2035 indicate continued growth in cases, with varying ASR trends. Inequality analyses revealed persistent disparities, disproportionately affecting populations with higher socioeconomic development.</p><p><strong>Conclusions: </strong>Significant disparities persist in the global burden of hernias, with increasing cases despite declining ASRs. Continued growth and inequalities underscore the need for targeted interventions and policies.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"91"},"PeriodicalIF":2.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407278","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":"Complex abdomen: a scoping review.","authors":"C Stabilini, S Capoccia Giovannini, G Campanelli, G Cavallaro, U Bracale, G Soliani, F Pecchini, M Frascio, F Carlini, G Longo, A Rubartelli, G Camerini","doi":"10.1007/s10029-025-03270-6","DOIUrl":"https://doi.org/10.1007/s10029-025-03270-6","url":null,"abstract":"<p><strong>Purpose: </strong>This scoping review aimed to systematically map the existing evidence on the surgical management of complex abdominal wall hernias (CA), focusing on patient-specific factors, hernia characteristics, contamination and operative strategies to their management, in order to identify research gaps and areas for clinical improvement.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed and Scopus, covering publications from January 2015 to June 2024. A total of 6,445 articles were identified, of which 357 met inclusion criteria (303 primary studies and 54 systematic reviews). Studies were classified into three categories: patient-related factors (P), hernia-specific features (H), and contamination (W).</p><p><strong>Results: </strong>Patient-related factors, particularly obesity and associated comorbidities, were consistently related to higher rates of morbidity and hernia recurrence despite prehabilitation and bariatric surgery were evaluated, results were inconclusive. Hernia-specific features, including large defect size and loss of domain, were associated with increased complication rates. Midline restoration and its achievement with component separation or preoperative botulinum toxin injections, were extensively studied, showing potential benefits. In contaminated settings, synthetic meshes outperformed biologic alternatives, demonstrating lower recurrence and morbidity rates in recent trials. Research in biosynthetic mesh is still needed.</p><p><strong>Conclusion: </strong>Surgical management of CA remains a highly demanding clinical scenario with significant variability in outcomes influenced by patient factors and hernia characteristics. Techniques such as component separation and the use of synthetic meshes hold promise, but further high-quality, randomized trials are required to establish standardized protocols and optimize clinical outcomes in this challenging patient population.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"90"},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382340","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":"Comparative analysis of polypropylene and dual mesh incisional hernia repair methods in open surgery following organ transplantation: a single-center retrospective cohort study.","authors":"Alireza Shamsaeefar, Bahram Amiri, Hamed Nikoupour, Kourosh Kazemi, Seyed Ali Moosavi, Nasrin Motazedian, Sahar Sohrabi Nazari, Saman Nikeghbalian, Seyed Ali Malekhosseini","doi":"10.1007/s10029-025-03275-1","DOIUrl":"https://doi.org/10.1007/s10029-025-03275-1","url":null,"abstract":"<p><strong>Purpose: </strong>Transplant patients face a risk of developing incisional hernias. Establishing a reliable and secure incisional hernia repair method for this patient population remains a challenge.</p><p><strong>Methods: </strong>In this retrospective cohort study, we gathered data from patients who had undergone liver and kidney transplantations and subsequently had developed postoperative incisional hernias. Patient follow-up was extended for a minimum of 18 months. Primary outcomes focused on recurrence, hematoma, and infection rates, comparing the complication profiles of propylene mesh and Dual Mesh incisional hernia repair methods.</p><p><strong>Results: </strong>122 transplant patients with incisional hernias were included. The incidence of recurrence and infection after incisional hernia repair surgery was 20.6% and 5.9% for Dual Mesh and 22.2% and 9.9% for polypropylene mesh (P = 0.721 and 1.000). In liver recipients, the Dual Mesh method showed a slightly lower incidence of recurrence (17.9% vs. 23.3%) and infection (3.6% vs. 10.0%) compared to polypropylene mesh (P = 0.782, 0.423). Kidney recipients exhibited insignificant higher recurrence (33.3% vs. 19%) and infection rates (16.7% vs. 9.5%) with Dual Mesh (P = 0.588, 0.545).</p><p><strong>Conclusions: </strong>The results suggest that while trends indicate a lower recurrence and infection rate with Dual Mesh in liver transplant patients and a slightly higher recurrence and infection rate with Dual Mesh in kidney transplant patients, these differences were not statistically significant. Therefore, no definitive advantage of one mesh type over the other can be concluded from the data.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"89"},"PeriodicalIF":2.6,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373815","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}