Prevention of Incisional Hernias by Prophylactic Mesh-augmented Reinforcement of Midline Laparotomies for Abdominal Aortic Aneurysm Treatment: Five-year Follow-up of a Randomized Controlled Trial.
Journal
Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354
Informations de publication
Date de publication:
01 10 2022
01 10 2022
Historique:
pubmed:
29
6
2022
medline:
14
9
2022
entrez:
28
6
2022
Statut:
ppublish
Résumé
The incidence of incisional hernias (IHs) after open repair of an abdominal aortic aneurysm (AAA) is high. Several randomized controlled trials have reported favorable results with the use of prophylactic mesh to prevent IHs, without increasing complications. In this analysis, we report on the results of the 60-month follow-up of the PRIMAAT trial. In a prospective, multicenter, open-label, randomized design, patients were randomized between prophylactic retrorectus mesh reinforcement (mesh group), and primary closure of their midline laparotomy after open AAA repair (no-mesh group). This article reports on the results of clinical follow-up after 60 months. If performed, ultrasonography or computed tomography were used for the diagnosis of IHs. Of the 120 randomized patients, 114 were included in the intention-to-treat analysis. Thirty-three patients in the no-mesh group (33/58-56.9%) and 34 patients in the mesh group (34/56-60.7%) were evaluated after 5 years. In each treatment arm, 10 patients died between the 24-month and 60-month follow-up. The cumulative incidence of IHs in the no-mesh group was 32.9% after 24 months and 49.2% after 60 months. No IHs were diagnosed in the mesh group. In the no-mesh group, 21.7% (5/23) underwent reoperation within 5 years due to an IH. Prophylactic retrorectus mesh reinforcement after midline laparotomy for the treatment of AAAs safely and effectively decreases the rate of IHs. The cumulative incidence of IHs after open AAA repair, when no mesh is used, continues to increase during the first 5 years after surgery, which leads to a substantial rate of hernia repairs.
Identifiants
pubmed: 35762612
doi: 10.1097/SLA.0000000000005545
pii: 00000658-202210000-00021
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e217-e222Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
M.M. reports having received research grants from Johnson and Johnson, FEG Textiltechnik, and Medtronic, speakers honorarium from Bard-Davol and Medtronic, and consultancy fees from Lifebond. T.T. reports having received research grants from Johnson and Johnson and Medtronic, speakers honorarium from Bard-Davol, and consultancy fees from Bard-Davol. F.B. reports having received research grants from Johnson and Johnson, speakers honorarium from Medtronic and Bard-Davol, and consultancy fees from Medtronic. F.M. reports having received research grants from Intuitive, Medtronic, and Dynamesh, speaker’s honorarium from Medtronic, Bard-Davol, Dynamesh, Intuitive, and WL Gore, and consultancy fees from Medtronic, Intuitive, and CMR Surgical. The remaining authors report no conflicts of interest.
Références
Indrakusuma R, Jalalzadeh H, van der Meij J, et al. Prophylactic mesh reinforcement versus sutured closure to prevent incisional hernias after open abdominal aortic aneurysm repair via midline laparotomy: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2018;56:120–128.
Alnassar S, Bawahab M, Abdoh A, et al. Incisional hernia postrepair of abdominal aortic occlusive and aneurysmal disease: five-year incidence. Vascular. 2012;20:273–277.
Pannu R, McPhail IR. Prevalence of abdominal wall hernia in participants with abdominal aortic aneurysm versus peripheral arterial disease--a population-based study. Angiology. 2012;63:146–149.
De Bruin J, Baas A, Buth J, et al. DREAM Study Group. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med. 2010;362:1881–1889.
Altieri M, Yang J, Jones T, et al. Incidence of ventral hernia repair after open abdominal aortic aneurysm and open aortofemoral or aortoiliac bypass surgery: an analysis of 17,594 patients in the state of New York. Am Surg. 2018;84:1388–1393.
Antoniou G, Georgiadis G, Antoniou S, et al. Abdominal aortic aneurysm and abdominal wall hernia as manifestations of a connective tissue disorder. J Vasc Surg. 2011;54:1175–1181.
Muysoms F, Antoniou S, Bury K, et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015;19:1–24.
Deerenberg E, Harlaar J, Steyerberg E, et al. Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. Lancet. 2015;386:1254–1260.
Muysoms F, Detry O, Vierendeels T, et al. Prevention of incisional hernias by prophylactic mesh-augmented reinforcement of midline laparotomies for abdominal aortic aneurysm treatment: a randomized controlled trial. Ann Surg. 2016;263:638–645.
Jairam A, Timmermans L, Eker H, et al. PRIMA Trialist Group. Prevention of incisional hernia with prophylactic onlay and sublay mesh reinforcement versus primary suture only in midline laparotomies (PRIMA): 2-year follow-up of a multicentre, double-blind, randomised controlled trial. Lancet. 2017;390:567–576; Erratum in: Lancet . 2017; 390: 554.
Bevis P, Windhaber R, Lear P, et al. Randomized clinical trial of mesh versus sutured wound closure after open abdominal aortic aneurysm surgery. Br J Surg. 2010;97:1497–1502.
Bali C, Papakostas J, Georgiou G, et al. A comparative study of sutured versus bovine pericardium mesh abdominal closure after open abdominal aortic aneurysm repair. Hernia. 2015;19:267–271.
Honig S, Diener H, Kölbel T, et al. for AIDA study group. Abdominal incision defect following AAA-surgery (AIDA): 2-year results of prophylactic onlay-mesh augmentation in a multicentre, double-blind, randomised controlled trial. Updates Surg. 2022;74:1105–1116.
Detry O, Berrevoet F, Muysoms F. Prevention of incisional hernia after midline laparotomy for abdominal aortic aneurysm repair. Updates Surg. 2022;74:1173–1174.
Nicolajsen C, Eldrup N. Abdominal closure and the risk of incisional hernia in aneurysm surgery—a systematic review and meta-analysis. Eur J Vasc Endovasc Surg. 2020;59:227–236.
Wanhainen A, Verzini F, Van Herzeele I, et al. Editor’s Choice—European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg. 2019;57:8–93.
Fischer J, Harris H, López-Cano M, et al. Hernia prevention: practice patterns and surgeons’ attitudes about abdominal wall closure and the use of prophylactic mesh. Hernia. 2019;23:329–334.
Van den Dop L, Sneiders D, Kleinrensink G, et al. Infectious complication in relation to the prophylactic mesh position: the PRIMA trial revisited. J Am Coll Surg. 2021;232:738–745.
Gillion J, Sanders D, Miserez M, et al. The economic burden of incisional ventral hernia repair: a multicentric cost analysis. Hernia. 2016;20:819–830.
Fischer J, Basta M, Wink J, et al. Cost-utility analysis of the use of prophylactic mesh augmentation compared with primary fascial suture repair in patients at high risk for incisional hernia. Surgery. 2015;158:700–711.
Alli V, Zhang J, Telem D. Impact of incisional hernia development following abdominal operations on total healthcare cost. Surg Endosc. 2018;32:2381–2386.
Gibello L, Verzini F, Spalla F, et al. Long-term outcomes of open and endovascular abdominal aortic repair in younger patients. Ann Vasc Surg. 2022;8:S0890–5096.
Garland S, Falster M, Beiles C, et al. Long term outcomes following elective repair of intact abdominal aortic aneurysms: a comparison between open surgical and endovascular repair using linked administrative and clinical registry data [published online October 20, 2021]. Ann Surg. doi: 10.1097/SLA.0000000000005259.
doi: 10.1097/SLA.0000000000005259
den Hartog D, Dur A, Kamphuis A, et al. Comparison of ultrasonography with computed tomography in the diagnosis of incisional hernias. Hernia. 2009;13:45–48.
Gruppo M, Mazzalai F, Lorenzetti R, et al. Midline abdominal wall incisional hernia after aortic reconstructive surgery: a prospective study. Surgery. 2012;151:882–888.