دورية أكاديمية
أعرض في EDS

Comparative long-term effectiveness between ventral hernia repairs with biosynthetic and synthetic mesh.

التفاصيل البيبلوغرافية
العنوان: Comparative long-term effectiveness between ventral hernia repairs with biosynthetic and synthetic mesh.
المؤلفون: Morrison BG; College of Medicine, University of Kentucky, Lexington, KY, USA., Gledhill K; College of Medicine, University of Kentucky, Lexington, KY, USA., Plymale MA; Division of General, Endocrine & Metabolic Surgery, Department of Surgery, University of Kentucky, C 240, Chandler Medical Center, 800 Rose Street, Lexington, KY, 40536, USA., Davenport DL; Division of Health Outcomes and Optimal Patient Services, Department of Surgery, University of Kentucky, Lexington, KY, USA., Roth JS; Division of General, Endocrine & Metabolic Surgery, Department of Surgery, University of Kentucky, C 240, Chandler Medical Center, 800 Rose Street, Lexington, KY, 40536, USA. s.roth@uky.edu.
المصدر: Surgical endoscopy [Surg Endosc] 2023 Aug; Vol. 37 (8), pp. 6044-6050. Date of Electronic Publication: 2023 Apr 28.
نوع المنشور: Review; Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE
أسماء مطبوعة: Publication: 1992- : New York : Springer
Original Publication: [Berlin] : Springer International, c1987-
مواضيع طبية MeSH: Surgical Mesh*/adverse effects , Hernia, Ventral*/surgery , Hernia, Ventral*/complications, Humans ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Surgical Wound Infection/surgery ; Prostheses and Implants/adverse effects ; Herniorrhaphy/methods ; Treatment Outcome ; Retrospective Studies
مستخلص: Background: Debate exists regarding the most appropriate type of mesh to use in ventral hernia repair (VHR). Meshes are broadly categorized as synthetic or biologic, each mesh with individual advantages and disadvantages. More recently developed biosynthetic mesh has characteristics of both mesh types. The current study aims to examine long-term follow-up data and directly compare outcomes-specifically hernia recurrence-of VHR with biosynthetic versus synthetic mesh.
Methods: With IRB approval, consecutive cases of VHR (CPT codes 49,560, 49,561, 49,565, and 49,566 with 49,568) performed between 2013 and 2018 at a single institution were reviewed. Local NSQIP data was utilized for patient demographics, perioperative characteristics, CDC Wound Class, comorbidities, and mesh type. A review of electronic medical records provided additional variables including hernia defect size, postoperative wound events to six months, duration of follow-up, and incidence of hernia recurrence. Longevity of repair was measured using Kaplan-Meier method and adjusted Cox proportional hazards regression.
Results: Biosynthetic mesh was used in 101 patients (23%) and synthetic mesh in 338 (77%). On average, patients repaired using biosynthetic mesh were older than those with synthetic mesh (57 vs. 52 years; p = .008). Also, ASA Class ≥ III was more common in biosynthetic mesh cases (70.3% vs. 55.1%; p = .016). Patients repaired with biosynthetic mesh were more likely than patients with synthetic mesh to have had a prior abdominal infection (30.7% vs. 19.8%; p = .029). Using a Kaplan-Meier analysis, there was not a significant difference in hernia recurrence between the two mesh types, with both types having Kaplan Meir 5-year recurrence-free survival rates of about 72%.
Conclusion: Using Kaplan-Meier analysis, synthetic mesh and biosynthetic mesh result in comparable hernia recurrence rates and surgical site infection rates in abdominal wall reconstruction patients with follow-up to as long as five years.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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فهرسة مساهمة: Keywords: Abdominal wall reconstruction; Biosynthetic mesh; Hernia recurrence; Recurrence-free survival; Synthetic mesh; Ventral hernia
تواريخ الأحداث: Date Created: 20230428 Date Completed: 20230714 Latest Revision: 20230725
رمز التحديث: 20230726
DOI: 10.1007/s00464-023-10082-1
PMID: 37118030
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-2218
DOI:10.1007/s00464-023-10082-1