Recurrence rate after absorbable tack fixation of mesh in laparoscopic incisional hernia repair.
Br J Surg
; 102(5): 541-7, 2015 Apr.
Article
in En
| MEDLINE
| ID: mdl-25703637
ABSTRACT
BACKGROUND:
The mesh fixation technique in laparoscopic incisional hernia repair may influence the rates of hernia recurrence and chronic pain. This study investigated the long-term risk of recurrence and chronic pain in patients undergoing laparoscopic incisional hernia repair with either absorbable or non-absorbable tacks for mesh fixation.METHODS:
This was a nationwide consecutive cohort study based on data collected prospectively concerning perioperative information and clinical follow-up. Patients undergoing primary, elective, laparoscopic incisional hernia repair with absorbable or non-absorbable tack fixation during a 4-year interval were included. Follow-up was by a structured questionnaire regarding recurrence and chronic pain, supplemented by clinical examination, and CT when indicated. Recurrence was defined as either reoperation for recurrence or clinical/radiological recurrence.RESULTS:
Of 1037 eligible patients, 84·9 per cent responded to the questionnaire, and 816 were included for analysis. The median observation time for the cohort was 40 (range 0-72) months. The cumulative recurrence-free survival rate was 71·5 and 82·0 per cent after absorbable and non-absorbable tack fixation respectively (P = 0·007). In multivariable analysis, the use of absorbable tacks was an independent risk factor for recurrence (hazard ratio 1·53, 95 per cent c.i. 1·11 to 2·09; P = 0·008). The rate of moderate or severe chronic pain was 15·3 and 16·1 per cent after absorbable and non-absorbable tack fixation respectively (P = 0·765).CONCLUSION:
Absorbable tack fixation of the mesh was associated with a higher risk of recurrence than non-absorbable tacks for laparoscopic mesh repair of incisional hernia, but did not influence chronic pain.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Surgical Mesh
/
Laparoscopy
/
Herniorrhaphy
/
Hernia, Ventral
Type of study:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
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Observational_studies
/
Qualitative_research
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Risk_factors_studies
Limits:
Adult
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Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Br J Surg
Year:
2015
Document type:
Article
Affiliation country:
Dinamarca