Long-term retromuscular and intraperitoneal mesh size changes within a randomized controlled trial on incisional hernia repair, including a review of the literature
(2017) In Hernia p.1-10- Abstract
Abstract: Purpose Ingrowth of fibroblasts in a polypropylene mesh may cause contraction and a later recurrence. We assessed mesh contraction in intraabdominal and retromuscular implantation after incisional hernia repair. Methods: A cohort of patients within an RCT on laparoscopic (LHR) versus open hernia repair (OHR) had their mesh borders marked with metal clips. X-ray was performed on postoperative day 1 and after 1 year. Total length, width, and dislocation were measured. A tacker fixated large-pore polypropylene mesh was used in LHR, and a retromuscular small-pore heavy-weight mesh was sutured to the midline in OHR. Patient’s pain was assessed before surgery and after 1 year. Results: For analysis 37/47 patients remained: 20 LHR... (More)
Abstract: Purpose Ingrowth of fibroblasts in a polypropylene mesh may cause contraction and a later recurrence. We assessed mesh contraction in intraabdominal and retromuscular implantation after incisional hernia repair. Methods: A cohort of patients within an RCT on laparoscopic (LHR) versus open hernia repair (OHR) had their mesh borders marked with metal clips. X-ray was performed on postoperative day 1 and after 1 year. Total length, width, and dislocation were measured. A tacker fixated large-pore polypropylene mesh was used in LHR, and a retromuscular small-pore heavy-weight mesh was sutured to the midline in OHR. Patient’s pain was assessed before surgery and after 1 year. Results: For analysis 37/47 patients remained: 20 LHR and 17 OHR. Hernia defect area was median 41 cm2 in LHR and 25 cm2 in OHR (p < 0.140). Implanted mesh size was 300 cm2 for LHR and 240 cm2 for OHR (p < 0.341). After 1 year the mesh area decreased by 4.4% and 0.5% in LHR and OHR, respectively (p < 0.063). Longitudinal distance decreased by 2.8% in LHR and by 2.6% in OHR (p < 0.269). Transverse distance decreased by 1.6% in LHR but increased by 3.1% in OHR (p < 0.005). Dislocation was seen in four LHR and one OHR. Two recurrent and one port-site hernia were diagnosed after LHR. Measurements between observers were identical in 58% and consensus was made in the remainder. Pain was not correlated to mesh area change. Conclusions: Mesh contraction after 1 year is not a clinical issue for an intraperitoneal large-pore mesh or a retromuscular small-pore mesh. It is not correlated to postoperative pain.
(Less)
- author
- Rogmark, P.
LU
; Ekberg, O. LU and Montgomery, A. LU
- organization
- publishing date
- 2017-06-20
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Incisional hernia repair, IPOM, Mesh contraction, Retromuscular mesh
- in
- Hernia
- pages
- 10 pages
- publisher
- Springer
- external identifiers
-
- pmid:28634690
- wos:000411557200004
- scopus:85021109970
- ISSN
- 1265-4906
- DOI
- 10.1007/s10029-017-1624-9
- language
- English
- LU publication?
- yes
- id
- e6a5f90d-9aac-46b4-93da-6a1964658508
- date added to LUP
- 2017-08-11 10:29:52
- date last changed
- 2025-01-07 18:28:48
@article{e6a5f90d-9aac-46b4-93da-6a1964658508, abstract = {{<p>Abstract: Purpose Ingrowth of fibroblasts in a polypropylene mesh may cause contraction and a later recurrence. We assessed mesh contraction in intraabdominal and retromuscular implantation after incisional hernia repair. Methods: A cohort of patients within an RCT on laparoscopic (LHR) versus open hernia repair (OHR) had their mesh borders marked with metal clips. X-ray was performed on postoperative day 1 and after 1 year. Total length, width, and dislocation were measured. A tacker fixated large-pore polypropylene mesh was used in LHR, and a retromuscular small-pore heavy-weight mesh was sutured to the midline in OHR. Patient’s pain was assessed before surgery and after 1 year. Results: For analysis 37/47 patients remained: 20 LHR and 17 OHR. Hernia defect area was median 41 cm<sup>2</sup> in LHR and 25 cm<sup>2</sup> in OHR (p < 0.140). Implanted mesh size was 300 cm<sup>2</sup> for LHR and 240 cm<sup>2</sup> for OHR (p < 0.341). After 1 year the mesh area decreased by 4.4% and 0.5% in LHR and OHR, respectively (p < 0.063). Longitudinal distance decreased by 2.8% in LHR and by 2.6% in OHR (p < 0.269). Transverse distance decreased by 1.6% in LHR but increased by 3.1% in OHR (p < 0.005). Dislocation was seen in four LHR and one OHR. Two recurrent and one port-site hernia were diagnosed after LHR. Measurements between observers were identical in 58% and consensus was made in the remainder. Pain was not correlated to mesh area change. Conclusions: Mesh contraction after 1 year is not a clinical issue for an intraperitoneal large-pore mesh or a retromuscular small-pore mesh. It is not correlated to postoperative pain.</p>}}, author = {{Rogmark, P. and Ekberg, O. and Montgomery, A.}}, issn = {{1265-4906}}, keywords = {{Incisional hernia repair; IPOM; Mesh contraction; Retromuscular mesh}}, language = {{eng}}, month = {{06}}, pages = {{1--10}}, publisher = {{Springer}}, series = {{Hernia}}, title = {{Long-term retromuscular and intraperitoneal mesh size changes within a randomized controlled trial on incisional hernia repair, including a review of the literature}}, url = {{http://dx.doi.org/10.1007/s10029-017-1624-9}}, doi = {{10.1007/s10029-017-1624-9}}, year = {{2017}}, }