External Validation of the European Hernia Society Classification for Postoperative Complications after Incisional Hernia Repair: A Cohort Study of 2,191 Patients

Kroese, Leonard F.; Kleinrensink, Gert-Jan; Lange, Johan F.; Gillion, J.-F.

doi:10.1016/j.jamcollsurg.2017.11.018

Cited by 28 publications

(18 citation statements)

References 22 publications

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“…In another study by Orenstein et al, it was stated that lightweight meshes lead to less foreign body feeling than heavyweight meshes [25]. Similarly, in several experimental studies, it was stated that TCM led to less foreign body reaction than identical meshes [26,27]. In this study, foreign body feeling was found to be significantly less in patients with TCM.…”

Section: Discussionsupporting

confidence: 60%

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The Effects of Onlay Titanium-coated Mesh on Recurrence, Foreign Body Feeling and Chronic Pain in Ventral Hernia

Akalın¹

2020

Preprint

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Background There are many complications of meshes in hernia repair. The aim of this study was to investigate the effects of onlay titanium-coated meshes (TCM) on recurrence, foreign body feeling and chronic pain in ventral hernia repair.Methods In this retrospective cohort study, patients who underwent TCM and polypropylene mesh (PM) for onlay repair of ventral hernia were examined between May 2014 and January 2018 at our centre. Patient characteristics, type of hernia, defect size, operative time, follow-up time, surgical site occurrence (infection, seroma and hematoma), recurrence, foreign body feeling and chronic pain were analysed. Patients were divided into two groups according to the mesh elected; TCM (titanium group) or PM (polypropylene group).Results Out of 160 patients, 63 (32.6%) had TCM and 97 (67.4%) had PM. There was no significant difference between groups in terms of recurrence (p = 0.757). Chronic pain and foreign body feeling were low in the titanium group (p = 0.047 and p = 0.029, respectively), a positive correlation was found between surgical site infection and recurrence (p = 0.020). In the polypropylene group, an increase in defect size was significantly associated with foreign body feeling and chronic pain (p < 0.001 for both comparisons).Conclusion In onlay repair of ventral hernia, TCM led to less foreign body feeling and chronic pain then PM. The surgical site infection was associated with recurrence for these meshes. Additionally, the increase in defect size causes a risk for foreign body feeling and chronic pain in repair using PM.

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Section: Discussionsupporting

confidence: 60%

“…Chronic pain is also a common complication of VHR and multifactorial in aetiology [28]. The most important factors in the aetiology are surgeon experience, surgical technique and mesh characteristic.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Onlay Titanium-coated Mesh on Recurrence, Foreign Body Feeling and Chronic Pain in Ventral Hernia

Akalın¹

2020

Preprint

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“…In registry studies there is essentially no difference between the proportion of men and women in the total collective of incisional hernias, with each accounting for 50% [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Köckerling

Hoffmann²,

Adolf

et al. 2019

Hernia

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Introduction To date, little attention has been paid by surgical scientific studies to sex as a potential influence factor on the outcome. Therefore, there is a sex bias in the surgical literature. With an incidence of more than 20% after 3 years, incisional hernias are a common complication following abdominal surgical procedures. The proportion of women affected is around 50%. There are very few references in the literature to the influence of sex on the outcome of elective incisional hernia repair. Materials and methods In all, 22,895 patients with elective incisional hernia repair from the Herniamed Registry were included in the study. The patients had undergone elective incisional hernia repair in a laparoscopic IPOM, open sublay, open IPOM, open onlay or suture technique. 1-year follow-up was available for all patients. Propensity score matching was performed for the 11,480 female (50.1%) and 11,415 male (49.9%) patients, creating 8138 pairs (82.0%) within fixed surgical procedures. Results For pain on exertion (11.7% vs 18.3%; p < 0.001), pain at rest (7.53% vs 11.1%; p < 0.001), and pain requiring treatment (5.4% vs 9.1%; p < 0.001) highly significant disadvantages were identified for the female sex when comparing the different results within the matched pairs. That was also confirmed on comparing sex within the individual surgical procedures. No sex-specific differences were identified for the postoperative complications, complication-related reoperations or recurrences. Less favorable intraoperative complication results in the female sex were observed only for the onlay technique. Conclusions Female sex is an independent risk factor for chronic pain after elective incisional hernia repair.

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“…They may be unsightly, cause pain, interfere with professional activities and have an impact on quality of life (QoL). While up to one-third of hernias is asymptomatic, surgical repair is generally recommended to reduce the risk of obstruction and strangulation [3].…”

Section: Introductionmentioning

confidence: 99%

Two-year patient-related outcome measures (PROM) of primary ventral and incisional hernia repair using a novel three-dimensional composite polyester monofilament mesh: the SymCHro registry study

Gillion¹,

Lepère

Barrat

et al. 2019

Hernia

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Purpose This study examined patient-related outcome measures (PROMs) after repair of ventral primary or incisional hernias using Symbotex™ composite mesh (SCM), a novel three-dimensional collagen-coated monofilament polyester textile. Methods Pre-operative, peri-operative, and post-operative data were obtained from the French “Club Hernie” registry with 12- and 24-month follow-up. Results One-hundred consecutive patients (mean age 62.0 ± 13.7; 51% female) underwent repair of 105 hernias: primary (39/105, 37.1%, defect area 5.2 ± 5.6 cm 2 ) and incisional (66/105, 62.9%, 31.9 ± 38.7.8 cm 2 ). The mean BMI was 29.7 (± 5.6 kg/m 2 ). American Society of Anesthesiologists classifications were I 39.4%, II 37.4% and III 23.2%. 75% had risk factors for healing and/or dissection. Of 38 primary repairs, 37 were completed laparoscopically (combined approach n = 1), and of 62 incisional hernia repairs, 40 were completed laparoscopically, and 20 by open repair (combined approach n = 2). Laparoscopic was quicker than open repair (36.2 ± 23.5 min vs. 67.4 ± 25.8, p < 0001). Before surgery, 86.3% of hernias were reported to cause discomfort/pain or dysesthesia. At 24 months (93 of 100 patients), 91 (97.8%) reported no lump and 81 (87.1%) no pain or discomfort. Of 91 patients, 86 (94.5%) rated their repair “good” or “excellent.” There were nine non-serious, surgeon-detected adverse events (ileus, n = 3; seroma, n = 6) and one hernia recurrence (6–12 months). Conclusions Compared to baseline, open and laparoscopic surgery improved PROMs 24 months after primary and incisional hernia repair. Minimal complications and recurrence support the long-term efficacy of SCM.

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External Validation of the European Hernia Society Classification for Postoperative Complications after Incisional Hernia Repair: A Cohort Study of 2,191 Patients

Abstract: Incisional hernia repair is associated with a 15% complication rate. The EHS width classification is associated with postoperative complications. To identify patients at risk for complications, the EHS classification is useful.

Cited by 28 publications

References 22 publications

The Effects of Onlay Titanium-coated Mesh on Recurrence, Foreign Body Feeling and Chronic Pain in Ventral Hernia

The Effects of Onlay Titanium-coated Mesh on Recurrence, Foreign Body Feeling and Chronic Pain in Ventral Hernia

Female sex as independent risk factor for chronic pain following elective incisional hernia repair: registry-based, propensity score-matched comparison

Two-year patient-related outcome measures (PROM) of primary ventral and incisional hernia repair using a novel three-dimensional composite polyester monofilament mesh: the SymCHro registry study

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