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Modified Peritoneal Flap Hernioplasty Versus Retromuscular Technique for Incisional Hernia Repair : a Retrospective Cohort Study

Petersson, P. LU ; Montgomery, A. LU and Petersson, U. LU (2019) In Scandinavian Journal of Surgery
Abstract

Background and Aims: We present an open retromuscular mesh technique for incisional hernia repair, the modified peritoneal flap hernioplasty, where the fascia is sutured to the mesh and the hernia sac utilized for anterior mesh coverage. The aim was to describe the modified peritoneal flap hernioplasty technique and to compare it to a retromuscular repair, without component separation, regarding short-term complications, patient satisfaction, abdominal wall complaints, and recurrent incisional hernia. Materials and Methods: Consecutive patients operated electively with modified peritoneal flap hernioplasty technique (December 2012–December 2015) or retromuscular technique (Jan 2011–Oct 2014) were included in a retrospective... (More)

Background and Aims: We present an open retromuscular mesh technique for incisional hernia repair, the modified peritoneal flap hernioplasty, where the fascia is sutured to the mesh and the hernia sac utilized for anterior mesh coverage. The aim was to describe the modified peritoneal flap hernioplasty technique and to compare it to a retromuscular repair, without component separation, regarding short-term complications, patient satisfaction, abdominal wall complaints, and recurrent incisional hernia. Materials and Methods: Consecutive patients operated electively with modified peritoneal flap hernioplasty technique (December 2012–December 2015) or retromuscular technique (Jan 2011–Oct 2014) were included in a retrospective single-center cohort study. Outcomes were evaluated from the Swedish Ventral Hernia Registry, by chart review, physical examination, and an abdominal wall complaints questionnaire. Results: The modified peritoneal flap hernioplasty group (n = 78) had larger hernias (mean width 10.4 vs 8.5 cm, p = 0.005), more advanced Centers for Disease Control classification (p = 0.009), and more simultaneous gastrointestinal-tract surgery (23.1% vs 11.5%, p = 0.041) than the retromuscular group (n = 96). No difference in short-term complications was seen. Incisional hernia recurrence was lower in the modified peritoneal flap hernioplasty group (1.4% vs 10.3%, p = 0.023), and patients were more satisfied (93.8% vs 81.7%, p = 0.032). Follow-up time was shorter in the modified peritoneal flap hernioplasty group (614 vs 1171 days, p < 0.001). Conclusion: This retrospective study showed similar rates of short-term complications, despite more complex hernias in the modified peritoneal flap hernioplasty group. Furthermore, a lower incisional hernia recurrence rate for the modified peritoneal flap hernioplasty technique compared with the retromuscular technique used in our department was found. If this holds true with equally long follow-up remains to be proven.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Abdominal incisional hernia, modified peritoneal flap hernioplasty, patient satisfaction, retromuscular mesh repair, wound complications
in
Scandinavian Journal of Surgery
publisher
Finnish Surgical Society
external identifiers
  • scopus:85069819734
ISSN
1457-4969
DOI
10.1177/1457496919863943
language
English
LU publication?
yes
id
d0af19ee-7962-45b7-8bd1-6ed6c8bee067
date added to LUP
2019-08-22 13:11:17
date last changed
2019-09-04 04:48:10
@article{d0af19ee-7962-45b7-8bd1-6ed6c8bee067,
  abstract     = {<p>Background and Aims: We present an open retromuscular mesh technique for incisional hernia repair, the modified peritoneal flap hernioplasty, where the fascia is sutured to the mesh and the hernia sac utilized for anterior mesh coverage. The aim was to describe the modified peritoneal flap hernioplasty technique and to compare it to a retromuscular repair, without component separation, regarding short-term complications, patient satisfaction, abdominal wall complaints, and recurrent incisional hernia. Materials and Methods: Consecutive patients operated electively with modified peritoneal flap hernioplasty technique (December 2012–December 2015) or retromuscular technique (Jan 2011–Oct 2014) were included in a retrospective single-center cohort study. Outcomes were evaluated from the Swedish Ventral Hernia Registry, by chart review, physical examination, and an abdominal wall complaints questionnaire. Results: The modified peritoneal flap hernioplasty group (n = 78) had larger hernias (mean width 10.4 vs 8.5 cm, p = 0.005), more advanced Centers for Disease Control classification (p = 0.009), and more simultaneous gastrointestinal-tract surgery (23.1% vs 11.5%, p = 0.041) than the retromuscular group (n = 96). No difference in short-term complications was seen. Incisional hernia recurrence was lower in the modified peritoneal flap hernioplasty group (1.4% vs 10.3%, p = 0.023), and patients were more satisfied (93.8% vs 81.7%, p = 0.032). Follow-up time was shorter in the modified peritoneal flap hernioplasty group (614 vs 1171 days, p &lt; 0.001). Conclusion: This retrospective study showed similar rates of short-term complications, despite more complex hernias in the modified peritoneal flap hernioplasty group. Furthermore, a lower incisional hernia recurrence rate for the modified peritoneal flap hernioplasty technique compared with the retromuscular technique used in our department was found. If this holds true with equally long follow-up remains to be proven.</p>},
  author       = {Petersson, P. and Montgomery, A. and Petersson, U.},
  issn         = {1457-4969},
  keyword      = {Abdominal incisional hernia,modified peritoneal flap hernioplasty,patient satisfaction,retromuscular mesh repair,wound complications},
  language     = {eng},
  month        = {07},
  publisher    = {Finnish Surgical Society},
  series       = {Scandinavian Journal of Surgery},
  title        = {Modified Peritoneal Flap Hernioplasty Versus Retromuscular Technique for Incisional Hernia Repair : a Retrospective Cohort Study},
  url          = {http://dx.doi.org/10.1177/1457496919863943},
  year         = {2019},
}