Preperitoneal Versus Retromuscular Mesh Repair for Ventral Abdominal Hernias: A Propensity Matched Analysis
- PDF / 295,404 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 108 Downloads / 267 Views
ORIGINAL ARTICLE
Preperitoneal Versus Retromuscular Mesh Repair for Ventral Abdominal Hernias: A Propensity Matched Analysis Mohamed Wejih Dougaz 1 & Mohamed Ali Chaouch 1 & Sarah Cherni 1 & Mehdi Khalfallah 1 & Hichem Jerraya 1 & Ibtissem Bouasker 1 & Ramzi Nouira 1 & Chadli Dziri 1 Received: 19 August 2019 / Accepted: 24 March 2020 # Association of Surgeons of India 2020
Abstract To compare retromuscular and preperitoneal mesh positioning in open ventral hernia mesh repair, we performed a retrospective and comparative study of patients who underwent retromuscular mesh repair (RMMR) and preperitoneal mesh repair (PPMR) for ventral abdominal hernias between January 2012 and December 2016. We used propensity score matching to adjust for potential baseline confounders between two groups. After propensity score matching, 68 patients who underwent RMMR were compared with 92 patients treated with PPMR. There was no difference between RMMR and PPMR regarding operative time (85.24 vs 65.34 min, p = 0.120), drainage duration, hospital stay (3.12 vs 1.7 days, p = 0.226), morbidity (20.5% vs 11.9%, p = 0.129), superficial abscess (p = 0.056), deep abscess (p = 0.188), hematoma (p = 0.220), and seroma (p = 0.593). PPMR was superior to RMMR in term of drainage rate, drainage quantity (128 ml vs 36 ml, p = 0.001), drainage duration (3.6 vs 4.14 days, p = 0.068), and re-hospitalisation rate (7 vs 1 patient, p = 0.011). The mean follow-up in RMMR group was 42.6 months and 35.9 months in PPMR group. Nineteen patients were lost in follow-up (10.3%). Median delay of recurrence was 20.3 months in RMMR group and 11.1 months in PPMR group. At 3-year follow-up, there was no statistically difference between the two groups regarding the recurrence (11 vs 9 patients, p = 0.33) and delay of recurrence (20.3 vs 11.1 months, p = 0.175). RMMR and PPMR present a good alternative for open sublay mesh repair. They are safe, efficient, and associated with comparable complication and recurrence rates. Keywords Mesh repair . Retromuscular sublay repair . Preperitoneal sublay repair . Open surgery . Sublay repair . Ventral hernia
Introduction Fascial defect involving the anterior abdominal wall is frequent [1, 2]. Surgery remains the only known treatment option for ventral hernia. Open mesh hernia repair improved the long-term outcomes of abdominal hernias compared to suture [3–5]. Several surgical procedures have been described (onlay repair, inlay repair, sublay repair, and underlay repair), making it difficult to choose the best procedure. It is suggested that sublay mesh repair has the lowest recurrence and surgical site infection in open anterior abdominal hernia repair [1, 6]. Sublay mesh repair refers to retromuscular prefascial mesh placement or preperitoneal retrofascial mesh placement [6]. * Mohamed Ali Chaouch [email protected] 1
Department B of General Surgery, Charles Nicolle Hospital, 1006 Tunis, Tunisia
The superiority of one of these two open procedures was not evaluated before. The aim of this study is to compare open r
Data Loading...
