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1.
Hernia ; 23(4): 767-781, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30887379

RESUMO

PURPOSE: This study examined patient-related outcome measures (PROMs) after repair of ventral primary or incisional hernias using Symbotex™ composite mesh (SCM), a novel three-dimensional collagen-coated monofilament polyester textile. METHODS: Pre-operative, peri-operative, and post-operative data were obtained from the French "Club Hernie" registry with 12- and 24-month follow-up. RESULTS: One-hundred consecutive patients (mean age 62.0 ± 13.7; 51% female) underwent repair of 105 hernias: primary (39/105, 37.1%, defect area 5.2 ± 5.6 cm2) and incisional (66/105, 62.9%, 31.9 ± 38.7.8 cm2). The mean BMI was 29.7 (± 5.6 kg/m2). American Society of Anesthesiologists classifications were I 39.4%, II 37.4% and III 23.2%. 75% had risk factors for healing and/or dissection. Of 38 primary repairs, 37 were completed laparoscopically (combined approach n = 1), and of 62 incisional hernia repairs, 40 were completed laparoscopically, and 20 by open repair (combined approach n = 2). Laparoscopic was quicker than open repair (36.2 ± 23.5 min vs. 67.4 ± 25.8, p < 0001). Before surgery, 86.3% of hernias were reported to cause discomfort/pain or dysesthesia. At 24 months (93 of 100 patients), 91 (97.8%) reported no lump and 81 (87.1%) no pain or discomfort. Of 91 patients, 86 (94.5%) rated their repair "good" or "excellent." There were nine non-serious, surgeon-detected adverse events (ileus, n = 3; seroma, n = 6) and one hernia recurrence (6-12 months). CONCLUSIONS: Compared to baseline, open and laparoscopic surgery improved PROMs 24 months after primary and incisional hernia repair. Minimal complications and recurrence support the long-term efficacy of SCM.


Assuntos
Materiais Revestidos Biocompatíveis/uso terapêutico , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Hérnia Incisional/cirurgia , Polietilenotereftalatos/uso terapêutico , Telas Cirúrgicas , Adulto , Idoso , Feminino , Humanos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Poliésteres , Recidiva , Fatores de Risco , Seroma/etiologia
2.
Hernia ; 20(5): 711-22, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27278220

RESUMO

PURPOSE: A case-control study was performed to compare laparoscopic ventral hernia repair (LVHR) using the Ventralight ST™ lightweight surgical mesh with LVHR using other types of mesh. METHODS: Adult patients undergoing intraperitoneal implantation of Ventralight ST™ during LVHR (Ventralight ST™ group; VG) over a 2-year period (2011-2013) were identified from the prospective French Hernia-Club registry. Patients undergoing elective LVHR using other types of intraperitoneal mesh in the first semester of 2013 formed the control group (CG). Patient, hernia and surgical characteristics, and postoperative outcomes after 8 days, 1 month, and 1 year were compared between the two groups. RESULTS: The VG comprised 90 LVHRs in 85 patients, and the CG 86 LVHRs in 81 patients. Patient, hernia and surgical characteristics were similar between the two groups, apart from the method of mesh fixation and the number of procedures involving fascial closure. A low rate of minor complications was observed in both groups at 1 month [4.4 % (VG) and 2.3 % (CG)], and the level of postoperative pain was similar in the two groups at Day 8 and 1 month. After 1 year, no complications, recurrences or cases of chronic pain had occurred in either group, and Quality-of-Life outcomes were similar. Patients rated their procedure as excellent or good in 96 % (VG) and 92 % (CG) of cases. CONCLUSIONS: Ventralight ST™ mesh is effective and well tolerated in LVHR, producing very low complication and recurrence rates in the short and medium term. The results are comparable to those achieved with other types of mesh.


Assuntos
Hérnia Ventral/cirurgia , Herniorrafia/métodos , Telas Cirúrgicas , Adjuvantes Imunológicos/administração & dosagem , Idoso , Estudos de Casos e Controles , Materiais Revestidos Biocompatíveis , Feminino , Seguimentos , Herniorrafia/efeitos adversos , Humanos , Ácido Hialurônico/administração & dosagem , Laparoscopia , Masculino , Pessoa de Meia-Idade , Recidiva , Sistema de Registros
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