补片重量与不良结果的关联:一项包括123,880例腹股沟疝修补术的队列研究。

IF 2.4 2区 医学 Q1 SURGERY
Hernia Pub Date : 2025-08-26 DOI:10.1007/s10029-025-03427-3
Brandon Cowan, Priscilla H Chan, Sahil S Patel, Heather A Prentice, Kenneth Sucher, Elizabeth W Paxton, Elliott R Brill, Lavina Malhotra, Francisca M Maertens, Gregory M Heitmann, Rouzbeh Mostaedi
{"title":"补片重量与不良结果的关联:一项包括123,880例腹股沟疝修补术的队列研究。","authors":"Brandon Cowan, Priscilla H Chan, Sahil S Patel, Heather A Prentice, Kenneth Sucher, Elizabeth W Paxton, Elliott R Brill, Lavina Malhotra, Francisca M Maertens, Gregory M Heitmann, Rouzbeh Mostaedi","doi":"10.1007/s10029-025-03427-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Surgeons lack conclusive evidence to guide mesh choice for inguinal hernia repair. We sought to evaluate risk for recurrence, reoperation, and chronic postoperative inguinal pain (CPIP) compared among different mesh weight classes.</p><p><strong>Methods: </strong>We conducted a cohort study including 123,880 repairs in adult patients who underwent first elective mesh-based inguinal hernia repair within a US integrated healthcare system (1/2010-6/2023). Mesh weight was categorized into lightweight (LW, < 50 g), medium-weight (MW, 50-90 g), and heavyweight (HW, > 90 g). Recurrence and reoperation during follow-up were primary outcomes while 5-year CPIP was a secondary outcome. Multivariable Cox regression was used to evaluate risk of primary outcomes, while multivariable logistic regression was used to evaluate the secondary outcome; all models included covariate adjustment and stratified by surgery type.</p><p><strong>Results: </strong>LW, MW, and HW mesh were used in 49.0% (n = 23,685), 3.8% (n = 1,811), and 47.2% (n = 22,815) of minimally invasive (MIS) procedures, respectively; and were used in 55.7% (n = 42,097), 25.4% (n = 19,183), and 18.9% (n = 14,289) of open procedures, respectively. Among MIS repairs, LW mesh was associated with a lower risk of recurrence, reoperation, and CPIP versus HW, and a lower risk of recurrence and reoperation versus MW. Among open repairs, no difference was seen between LW and MW for recurrence, reoperation, and CPIP, while HW had a lower risk for recurrence and reoperation, but a higher likelihood of CPIP compared to LW.</p><p><strong>Conclusion: </strong>LW mesh was associated with a long-term advantage with fewer postoperative complications for MIS repair. HW mesh was associated with higher CPIP risk following an open repair.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"258"},"PeriodicalIF":2.4000,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of mesh weight with adverse outcomes: a cohort study including 123,880 inguinal hernia repairs.\",\"authors\":\"Brandon Cowan, Priscilla H Chan, Sahil S Patel, Heather A Prentice, Kenneth Sucher, Elizabeth W Paxton, Elliott R Brill, Lavina Malhotra, Francisca M Maertens, Gregory M Heitmann, Rouzbeh Mostaedi\",\"doi\":\"10.1007/s10029-025-03427-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Surgeons lack conclusive evidence to guide mesh choice for inguinal hernia repair. We sought to evaluate risk for recurrence, reoperation, and chronic postoperative inguinal pain (CPIP) compared among different mesh weight classes.</p><p><strong>Methods: </strong>We conducted a cohort study including 123,880 repairs in adult patients who underwent first elective mesh-based inguinal hernia repair within a US integrated healthcare system (1/2010-6/2023). Mesh weight was categorized into lightweight (LW, < 50 g), medium-weight (MW, 50-90 g), and heavyweight (HW, > 90 g). Recurrence and reoperation during follow-up were primary outcomes while 5-year CPIP was a secondary outcome. Multivariable Cox regression was used to evaluate risk of primary outcomes, while multivariable logistic regression was used to evaluate the secondary outcome; all models included covariate adjustment and stratified by surgery type.</p><p><strong>Results: </strong>LW, MW, and HW mesh were used in 49.0% (n = 23,685), 3.8% (n = 1,811), and 47.2% (n = 22,815) of minimally invasive (MIS) procedures, respectively; and were used in 55.7% (n = 42,097), 25.4% (n = 19,183), and 18.9% (n = 14,289) of open procedures, respectively. Among MIS repairs, LW mesh was associated with a lower risk of recurrence, reoperation, and CPIP versus HW, and a lower risk of recurrence and reoperation versus MW. Among open repairs, no difference was seen between LW and MW for recurrence, reoperation, and CPIP, while HW had a lower risk for recurrence and reoperation, but a higher likelihood of CPIP compared to LW.</p><p><strong>Conclusion: </strong>LW mesh was associated with a long-term advantage with fewer postoperative complications for MIS repair. HW mesh was associated with higher CPIP risk following an open repair.</p>\",\"PeriodicalId\":13168,\"journal\":{\"name\":\"Hernia\",\"volume\":\"29 1\",\"pages\":\"258\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-08-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hernia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10029-025-03427-3\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03427-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

摘要

目的:外科医生缺乏确凿的证据来指导腹股沟疝修补术中补片的选择。我们试图评估不同网片重量级别的复发、再手术和术后慢性腹股沟疼痛(CPIP)的风险。方法:我们进行了一项队列研究,包括在美国综合医疗系统(2010年1月至2023年6月)内接受首次选择性基于网状物的腹股沟疝修补术的123,880名成年患者。网重分为轻量化(LW, 90 g)。随访期间复发和再手术为主要结局,5年CPIP为次要结局。主要结局风险采用多变量Cox回归评估,次要结局风险采用多变量logistic回归评估;所有模型均包含协变量调整并按手术类型分层。结果:LW、MW和HW补片分别用于49.0% (n = 23,685)、3.8% (n = 1,811)和47.2% (n = 22,815)的微创(MIS)手术;55.7% (n = 42,097)、25.4% (n = 19,183)和18.9% (n = 14,289)的开放式手术均使用该方法。在MIS修复中,与HW相比,LW补片的复发、再手术和CPIP风险较低,与MW相比,LW补片的复发和再手术风险较低。在开放式修复中,LW和MW在复发、再手术和CPIP方面没有差异,而HW的复发和再手术风险较低,但与LW相比,CPIP的可能性较高。结论:LW补片在MIS修复中具有长期优势,术后并发症较少。HW补片与开放式修复后较高的CPIP风险相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of mesh weight with adverse outcomes: a cohort study including 123,880 inguinal hernia repairs.

Purpose: Surgeons lack conclusive evidence to guide mesh choice for inguinal hernia repair. We sought to evaluate risk for recurrence, reoperation, and chronic postoperative inguinal pain (CPIP) compared among different mesh weight classes.

Methods: We conducted a cohort study including 123,880 repairs in adult patients who underwent first elective mesh-based inguinal hernia repair within a US integrated healthcare system (1/2010-6/2023). Mesh weight was categorized into lightweight (LW, < 50 g), medium-weight (MW, 50-90 g), and heavyweight (HW, > 90 g). Recurrence and reoperation during follow-up were primary outcomes while 5-year CPIP was a secondary outcome. Multivariable Cox regression was used to evaluate risk of primary outcomes, while multivariable logistic regression was used to evaluate the secondary outcome; all models included covariate adjustment and stratified by surgery type.

Results: LW, MW, and HW mesh were used in 49.0% (n = 23,685), 3.8% (n = 1,811), and 47.2% (n = 22,815) of minimally invasive (MIS) procedures, respectively; and were used in 55.7% (n = 42,097), 25.4% (n = 19,183), and 18.9% (n = 14,289) of open procedures, respectively. Among MIS repairs, LW mesh was associated with a lower risk of recurrence, reoperation, and CPIP versus HW, and a lower risk of recurrence and reoperation versus MW. Among open repairs, no difference was seen between LW and MW for recurrence, reoperation, and CPIP, while HW had a lower risk for recurrence and reoperation, but a higher likelihood of CPIP compared to LW.

Conclusion: LW mesh was associated with a long-term advantage with fewer postoperative complications for MIS repair. HW mesh was associated with higher CPIP risk following an open repair.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Hernia
Hernia SURGERY-
CiteScore
4.90
自引率
26.10%
发文量
171
审稿时长
4-8 weeks
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信