One-year follow-up after incisional hernia treatment: results of a prospective randomized study

Venclauskas, Linas; Maleckas, Almantas; Kiudelis, Mindaugas

doi:10.1007/s10029-010-0686-8

Cited by 86 publications

(100 citation statements)

References 27 publications

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“…This study is almost comparable to present study. 12 Weber et al conducted study on 550 patients and noticed recurrence in 22(12.2%) patients in onlay technique and 53(14.4%) in sublay technique as patients considered in sublay technique (369). So, recurrence rate is more in sublay technique.…”

Section: Discussionmentioning

confidence: 99%

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

et al. 2018

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Background: Incisional hernia (IH) remains a very frequent postoperative complication and common hernias in middle aged population more commonly in females. The two techniques most frequently used are the onlay repair and sublay repair. Various studies have been conducted to compare the advantages and disadvantages of sublay and onlay mesh repair in incisional hernia and the superiority of sublay mesh repair. These studies whether they hold good for the population is a pertinent question. In view of this, author need to study the appropriate surgical techniques sublay versus onlay repair in the set up.Methods: Author conducted randomized comparative study of 100 patients having incisional hernia admitted to various surgical units of SNMC and HSK Hospital, Bagalkot during the period December 2014 to June 2016.Results: In present study of 100 cases, females have more incidence of incisional hernias than males. In onlay technique seroma formation was found in 72% of patients postoperatively and 4% in sublay technique. Surgical site infection (SSIN) was noticed in 8% of sublay technique whereas 12% in onlay technique. There is no recurrence in sublay group whereas onlay had 12% recurrence.Conclusions: Sublay technique is superior to onlay concerning the hospital stay, complications and recurrence.

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Section: Discussionmentioning

confidence: 99%

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

et al. 2018

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“…Factors that influence recurrences in hernia surgery include inadequate surgical technique, size of the hernia, obesity, wound site infection, cigarette smoking, diabetes, COPD, advanced age, and the use of steroid. [18][19][20][21][22] Recurrence rate has been reported in the literature as 1-22% for incarcerated inguinal hernias [23,24] and as 1-10% for incarcerated femoral hernias. [25] In the present study, recurrence was determined in totally 8 (4.2%) cases; the recurrence rate was highest in inguinal hernia (n=6, 5.9%) as compared to all hernia types.…”

Section: Discussionmentioning

confidence: 99%

Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

Özkan¹,

Yıldız²,

Çakır³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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AMAÇBu çalışmada, acil cerrahi kliniğimizde boğulmuş abdominal duvar hernisi nedeniyle ameliyat edilen hastalarda morbidite ve mortaliteyle ilişkili risk faktörlerinin insidansı araştırıldı. GEREÇ VE YÖNTEMHastalar hem fıtık türüne göre (inguinal, umblikal, insizyonel, femoral) kendi aralarında hem de morbidite ve mortalite üzerine etkili faktörler bakımından; yaş, cinsiyet, Amerikan Anesteziyoloji Derneği (AAD) skoru, anestezi tipi, eşlik eden hastalıklar, intestinal boğulma ve nekroz varlığı gibi verilerle değerlendirildi. BULGULARİnguinal herni erkeklerde, umblikal ve femoral herni kadınlarda sıktı (p<0,001). Femoral hernide boğulma ve nekrozdan dolayı intestinal rezeksiyon diğer fıtık türleri-ne göre anlamlı olarak yüksek saptandı (sırasıyla, p<0,005 ve p<0,001). Morbidite ve mortalite üzerine; ileri yaş (≥65 yaş), ek hastalık, strangülasyon, nekroz, yüksek AAD skoru (III, IV), semptomların başlama ve hastaneye başvuru süresinin anlamlı etkisi bulundu. Genel anestezinin de morbidite için risk oluşturduğu görüldü (p<0,05). SONUÇBoğulmuş abdominal duvar hernileri yüksek morbidite ve mortalite oranına sahip bir cerrahi problemdir. Bu yüzden herni saptandığında elektif koşullarda ameliyat planlanmalıdır.Anahtar Sözcükler: Abdominal duvar hernisi; inkarserasyon; nekroz; strangülasyon. BACKGROUNDThe aim of the present study was to investigate morbidityand mortality-related risk factors in patients undergoing surgery due to incarcerated abdominal wall hernia. METHODSThe patients were grouped according to the type of hernia (inguinal, umbilical, incisional, femoral), and these groups were evaluated in terms of risk factors affecting morbidity and mortality such as age, gender, American Society of Anesthesiologists (ASA) score, type of anesthesia, concomitant diseases, and the presences of intestinal strangulation and necrosis. RESULTSInguinal hernia was frequent in males, whereas femoral hernia was frequent in females (p<0.001). The rate of intestinal resection due to strangulation and necrosis was found significantly higher among femoral hernias as compared to the other types of hernia (p<0.005 and p<0.001, respectively). Advanced age (≥65 years), concomitant disease, strangulation, necrosis, high ASA score (III-IV), time from the onset of symptoms, and time to hospital admission were found to have significant influences on morbidity and mortality. General anesthesia was found to be a risk factor for morbidity as well (p<0.05). CONCLUSIONIncarcerated abdominal wall hernias are surgical problems with high morbidity and mortality rates. Therefore, surgery should be planned under elective conditions when hernia is detected.

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“…Wound complications such as infection, seroma, and hematoma increase the risk of recurrence by 4.1, 3.4, and 3.5 times, respectively (15). In a randomized prospective study, Venclauskas et al (18) reported that onlay mesh repair requires less time than sublay mesh repair. Moreover, they reported that sublay mesh repair had a lower postoperative complication rate.…”

Section: Incisional Hernia Remains a Major Problem After Laparotomymentioning

confidence: 99%

“…Den Hartog et al (20) reported recurrence rates of 7.4% by onlay mesh repair and 13.6% by sublay mesh repair. Moreover, Venclauskas et al (18) reported recurrence rates of 10.5% using onlay mesh repair and 2% using sublay mesh repair. In a meta-analysis, Mathes et al (22) reported no difference in recurrence rates.…”

Section: Incisional Hernia Remains a Major Problem After Laparotomymentioning

confidence: 99%

Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia

Sevinç

Okuş

et al. 2018

Turk J Surg

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Objective: Incisional hernia is a significant problem after laparotomy, and there is still no consensus on an ideal treatment method. The aim of this study was to compare the results of onlay and sublay mesh repair techniques. Material and Methods:In this randomized prospective trial, 100 patients were divided into two groups: onlay and sublay groups. Recurrences were evaluated by performing a physical examination. Results:The median follow-up was 37.1 (26.6 to 46.5) months. In the onlay group, the mean operation time was significantly shorter. However, in terms of postoperative pain and wound complications, the sublay group had significantly better results. The recurrence rates were found to be similar in both groups (6% in the onlay group and 2% in the sublay group). Conclusion:In the treatment of incisional hernia, sublay mesh repair is superior to onlay mesh repair in terms of postoperative pain and wound complications. Both techniques have similar recurrence rates. Keywords:Incisional hernia, mesh repair, onlay, sublay INTRODUCTIONIncisional hernia is a significant complication after laparotomy; its incidence ranges between 10% and 20% (1-4). This common problem can result in bowel strangulation, pain, and enterocutaneous fistula, and it affects the quality of life. The results of repair techniques vary widely. High recurrence rates have been reported for suture techniques, whereas mesh placement can reduce recurrence (5-10). In mesh repair, one of the most important problems is the placement of the mesh. Some techniques are reported to be associated with particularly high rates of some complications, such as recurrence, wound infection, and fistula (11,12). In the literature, several studies compare mesh and suture repair techniques, open and laparoscopic repair techniques, and mesh type as well as the plane in which the mesh should be placed. Currently, there is no consensus regarding the abdominal plane in which the mesh should be placed (13).The aim of this study was to compare the early and late results of onlay and sublay mesh repair techniques. , an American Society of Anesthesiologists score (ASA) of 4, or severe pulmonary or cardiac disease were not included. The remaining patients who agreed to be involved and signed the informed consent form were randomized into two groups: onlay group and sublay group. After the initial evaluation, 100 patients were included and were randomized to each group by the closed envelope method. The patients' demographic data, BMI, diameter of fascial defects, operation time (from first incision to dressing), visual analog scale (VAS) scores at the second and 24 th hours, length of hospital stay, drain takeoff time, postoperative complications, and recurrences were recorded. The fascial defect diameter was measured intraoperatively and is presented in cm 2 . All operations were performed according to the elective standard. There were no emergency operations. MATERIAL AND METHODS Operative TechniqueAll operations were performed under general anesthesia, and no antibioti...

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One-year follow-up after incisional hernia treatment: results of a prospective randomized study

Abstract: Mesh repair is the first-choice technique for incisional hernia treatment. The results of the "Sublay" technique are better than the "Onlay" technique.

Cited by 86 publications

References 27 publications

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

Open mesh repair, is still a standard technique for incisional hernia: a comparision study between sublay and onlay technique in the era of laparoscopy

Incarcerated abdominal wall hernia surgery: relationship between risk factors and morbidity and mortality rates (a single center emergency surgery experience)

Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia

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