Assessment of ideal ratio of mesh area to number of fixation tacks in laparoscopic ventral and incisional IPOM Plus hernia repair.
IPOM plus
Laparoscopic ventral hernia repair
Mesh fixation
Mesh-tack ratio
Tacks
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
10
11
2019
accepted:
02
03
2020
pubmed:
14
3
2020
medline:
21
7
2021
entrez:
14
3
2020
Statut:
ppublish
Résumé
To clarify the optimum mesh-tack ratio MTR (mesh area in cm In a retrospective cohort study, 84 patients (mean hernia width 6.6 ± 4.4 cm) intraoperatively received an intensive mesh fixation I-IPOM Plus with MTR ≤ 4:1 (e.g. ,150 cm After a mean follow-up time of 34 months, a 2.3% recurrence rate in I-IPOM Plus patients and a 13.5% recurrence rate in S-IPOM Plus patients were recorded (p = 0.018). The recurrence was associated with large hernia > 10 cm (OR 3.7, 95% CI 1.3-5.4) and MTR > 5 (OR 2.4, 95% CI 1.1-3.8) in the multivariate analysis. There was a positive correlation between immediate postoperative pain intensity measured on day 7 and number of fixation tacks placed (I-IPOM Plus: mean 4.5 ± 2.5 VAS versus S-IPOM Plus: mean 2.7 ± 2.0 VAS, p = 0.001). However, there were no outcome differences in terms of length of immediate postoperative pain experience, sick leave duration, chronic pain rate and long-term abdominal wall functionality between these two groups. For ventral and incisional hernia patients with multiple recurrence risk factors, a mesh-tack ratio MTR ≤ 4:1 should be applied in laparoscopic IPOM Plus procedures.
Sections du résumé
BACKGROUND
To clarify the optimum mesh-tack ratio MTR (mesh area in cm
METHODS
In a retrospective cohort study, 84 patients (mean hernia width 6.6 ± 4.4 cm) intraoperatively received an intensive mesh fixation I-IPOM Plus with MTR ≤ 4:1 (e.g. ,150 cm
RESULTS
After a mean follow-up time of 34 months, a 2.3% recurrence rate in I-IPOM Plus patients and a 13.5% recurrence rate in S-IPOM Plus patients were recorded (p = 0.018). The recurrence was associated with large hernia > 10 cm (OR 3.7, 95% CI 1.3-5.4) and MTR > 5 (OR 2.4, 95% CI 1.1-3.8) in the multivariate analysis. There was a positive correlation between immediate postoperative pain intensity measured on day 7 and number of fixation tacks placed (I-IPOM Plus: mean 4.5 ± 2.5 VAS versus S-IPOM Plus: mean 2.7 ± 2.0 VAS, p = 0.001). However, there were no outcome differences in terms of length of immediate postoperative pain experience, sick leave duration, chronic pain rate and long-term abdominal wall functionality between these two groups.
CONCLUSION
For ventral and incisional hernia patients with multiple recurrence risk factors, a mesh-tack ratio MTR ≤ 4:1 should be applied in laparoscopic IPOM Plus procedures.
Identifiants
pubmed: 32166548
doi: 10.1007/s00464-020-07493-9
pii: 10.1007/s00464-020-07493-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1230-1237Références
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