A vast majority of open surgical repair of incisional hernias are achieved using a prosthetic mesh. Even though it is a tensionless repair, it is still associated with early or late complications such as mesh infection, surgical site infection, chronic pain, seroma, hematoma, mesh shrinkage, etc. The recurrence rate following mesh repair is still as high as approximately 32 % over a 10year follow-up period. 5 A number of factors can influence these complication rates, comprising the position and site ABSTRACT From the patient's perspective, a ventral hernia can cause pain, adversely affect function, increase size, cosmetically distort the abdomen, and incarcerate/strangulate abdominal contents. The only known cure for a ventral hernia is surgical repair. The purpose of the current analysis was to review the published randomized controlled trials (RCTs) of the surgical care of ventral hernia. We conducted this meta-analysis using a comprehensive search of EMBASE, MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials till 01 March 2018 for randomized controlled trials on the use of mesh reinforcement in abdominal wall hernia repair. 15 studies met the search criteria, laparoscopic repair (OR 0.59; 95% CI 0.02-6.71) had the highest probability of having the lowest rate of surgical site infection. Among open mesh repair techniques, sublay repair (OR 1.41; 95% CI 0.01-5.99) had the highest probability of being the best treatment. Among patients experiencing ventral hernia repair, mesh reinforcement ought to be used regularly when there is no infection. Sublay mesh might outcome in fewer reappearances and surgical site infections. The quality of evidence to support these recommendations is moderate to high.
Introduction We studied the effect of tricuspid valve (TV) surgery combined with surgical ventricular restoration (SVR) on operative outcomes, rehospitalization, recurrent tricuspid regurgitation, and survival of patients with ischemic cardiomyopathy. Additionally, surgery was compared to conservative management in patients with mild or moderate tricuspid regurgitation. To the best of our knowledge, the advantage of combining TV surgery with SVR in patients with ischemic cardiomyopathy had not been investigated before. Methods This retrospective cohort study included 137 SVR patients who were recruited from 2009 to 2020. Patients were divided into two groups - those with no concomitant TV surgery (n=74) and those with concomitant TV repair or replacement (n=63). Results Extracorporeal membrane oxygenation use was higher in SVR patients without TV surgery (P=0.015). Re-exploration and blood transfusion were significantly higher in those with TV surgery (P=0.048 and P=0.037, respectively). Hospital mortality occurred in eight (10.81%) patients with no TV surgery vs. five (7.94%) in the TV surgery group (P=0.771). Neither rehospitalization (log-rank P=0.749) nor survival (log-rank P=0.515) differed in patients with mild and moderate tricuspid regurgitation in both groups. Freedom from recurrent tricuspid regurgitation was non-significantly higher in mild and moderate tricuspid regurgitation patients with no TV surgery (P=0.059). Conservative management predicted the recurrence of tricuspid regurgitation. Conclusion TV surgery concomitant with SVR could reduce the recurrence of tricuspid regurgitation; however, its effect on the clinical outcomes of rehospitalization and survival was not evident. The same effects were observed in patients with mild and moderate tricuspid regurgitation.
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