NorthShore University Health System, 1000 Central St Suite 800, Evanston, IL, 60201, USA.
Novant Health Bariatric Solutions-Salisbury, Salisbury, NC, USA.
Surg Endosc. 2023 May;37(5):3455-3462. doi: 10.1007/s00464-022-09803-9. Epub 2022 Dec 22.
One-year device safety and clinical outcomes of ventral hernia repair with the GORE® SYNECOR Intraperitoneal Biomaterial, a hybrid composite mesh was evaluated.
This retrospective, multicenter, case review analyzed device/procedure endpoints and patient-reported outcomes in patients treated for hernia repair ≥ 1 year from study enrollment.
Included were 459 patients (with 469 ventral hernias) with a mean age of 58 ± 15 years; 77.1% met Ventral Hernia Working Group 2 (VHWG2) classification. Mean hernia size was 18.9 cm and 57.3% of hernias were incisional. Laparoscopic or robotic approach was utilized in 95.4% of patients. Mesh location was intraperitoneal for 75.6% and bridging repair was performed in 57.3%. Procedure-related adverse events within 30-days occurred in 5.0% of patients and included surgical site infection (SSI), surgical site occurrence (SSO), ileus, readmission, and re-operation. Procedure-related SSI or SSO events were 3.8% through 12 months. SSO events requiring procedural intervention (SSOPI) were 2.6% through 24 months. Four patients (0.9%) had confirmed hernia recurrence through the study (the mean follow-up was 32-months, range 14-53 months). Subgroup comparisons were conducted for all type recurrence; only diabetes was found to be statistically significant (p = .0506).
In this analysis, ventral hernia repair with hybrid, composite mesh results in successful outcomes in most patients. This study represents a heterogeneous patient population undergoing repair using various approaches, mesh fixation, and mesh placement locations. These data appear to confirm long-term acceptable safety and device performance with a low rate of recurrence in a predominantly VHWG2 population.
评估了 Gore® SYNECOR 腹腔内生物材料(一种混合复合材料网片)用于腹疝修补的 1 年设备安全性和临床结果。
这项回顾性、多中心病例研究分析了从研究入组开始治疗后至少 1 年的患者的设备/程序终点和患者报告的结果。
共纳入 459 例(469 例腹疝)患者,平均年龄 58±15 岁;77.1%符合腹疝工作组 2 (VHWG2)分类。平均疝大小为 18.9cm,57.3%的疝为切口疝。95.4%的患者采用腹腔镜或机器人入路。75.6%的网片位于腹腔内,57.3%行桥接修补。30 天内发生的与手术相关的不良事件发生率为 5.0%,包括手术部位感染(SSI)、手术部位事件(SSO)、肠梗阻、再入院和再次手术。12 个月内与手术相关的 SSI 或 SSO 发生率为 3.8%。24 个月内需要手术干预的 SSO 事件(SSOPI)发生率为 2.6%。4 例(0.9%)患者在研究期间出现了确诊的疝复发(平均随访时间为 32 个月,范围 14-53 个月)。对所有类型的复发进行了亚组比较;只有糖尿病具有统计学意义(p=0.0506)。
在这项分析中,混合复合材料网片用于腹疝修补术可使大多数患者获得成功的结果。本研究代表了一个异质的患者群体,他们接受了各种方法、网片固定和网片放置位置的修复。这些数据似乎证实了在以 VHWG2 为主的人群中,该设备具有长期可接受的安全性和较低的复发率。