University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC, 27514, USA.
Vanderbilt University, Nashville, USA.
Surg Endosc. 2024 May;38(5):2871-2878. doi: 10.1007/s00464-024-10778-y. Epub 2024 Apr 12.
The use of mesh is standard of care for large ventral hernias repaired on an elective basis. The most used type of mesh includes synthetic polypropylene mesh; however, there has been an increase in the usage of a new polyester self-gripping mesh, and there are limited data regarding its efficacy for ventral hernia. The purpose of the study is to determine whether there is a difference in surgical site occurrence (SSO), surgical site infection (SSI), surgical site occurrence requiring procedural intervention (SSOPI), and recurrence at 30 days after ventral hernia repair (VHR) using self-gripping (SGM) versus non-self-gripping mesh (NSGM).
We performed a retrospective study from January 2014 to April 2022 using the Abdominal Core Health Quality Collaborative (ACHQC). We collected data on patients over 18 years of age who underwent elective open VHR using SGM or NSGM and whom had 30-day follow-up. Propensity matching was utilized to control for variables including hernia width, body mass index, age, ASA, and mesh location. Data were analyzed to identify differences in SSO, SSI, SSOPI, and recurrence at 30 days.
9038 patients were identified. After propensity matching, 1766 patients were included in the study population. Patients with SGM had similar demographic and clinical characteristics compared to NSGM. The mean hernia width to mesh width ratio was 8 cm:18 cm with NSGM and 7 cm:15 cm with SGM (p = 0.63). There was no difference in 30-day rates of recurrence, SSI or SSO. The rate of SSOPI was also found to be 5.4% in the nonself-gripping group compared to 3.1% in the self-gripping mesh group (p < .005). There was no difference in patient-reported outcomes at 30 days.
In patients undergoing ventral hernia repair with mesh, self-gripping mesh is a safe type of mesh to use. Use of self-gripping mesh may be associated with lower rates of SSOPI when compared to nonself-gripping mesh.
在择期修复大型腹疝时，使用网片是标准治疗方法。最常用的网片类型包括合成聚丙烯网片；然而，新型聚酯自固位网片的使用有所增加，关于其用于腹疝的疗效的数据有限。本研究的目的是确定在 30 天腹疝修复（VHR）后，使用自固位（SGM）与非自固位网片（NSGM）修复腹疝时，手术部位发生（SSO）、手术部位感染（SSI）、需要手术干预的手术部位发生（SSOPI）和复发是否存在差异。
我们使用腹部核心健康质量协作（ACHQC）进行了一项从 2014 年 1 月至 2022 年 4 月的回顾性研究。我们收集了 18 岁以上接受 SGM 或 NSGM 择期开放 VHR 且有 30 天随访的患者的数据。利用倾向评分匹配来控制变量，包括疝宽度、体重指数、年龄、ASA 和网片位置。分析数据以确定 30 天内 SSO、SSI、SSOPI 和复发的差异。
共确定了 9038 名患者。在进行倾向评分匹配后，有 1766 名患者纳入研究人群。SGM 患者的人口统计学和临床特征与 NSGM 患者相似。NSGM 的平均疝宽与网片宽比为 8cm:18cm，SGM 为 7cm:15cm（p=0.63）。30 天复发率、SSI 或 SSO 无差异。非自固位组的 SSOPI 发生率也为 5.4%，而自固位网片组为 3.1%（p<.005）。30 天患者报告的结果无差异。
在接受网片修复腹疝的患者中，自固位网片是一种安全的网片类型。与非自固位网片相比，使用自固位网片可能与较低的 SSOPI 发生率相关。
