Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair

O’Dwyer, P. J.; Kingsnorth, Andrew; Molloy, R. G.; Small, Peter; Lammers, B. J.; Horeyseck, G.

doi:10.1002/bjs.4833

Cited by 308 publications

(266 citation statements)

References 11 publications

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“…Importantly, this does not increase the recurrence rate at one year (range 6-60 months), although caution is still needed in large (direct) hernias with a potential increased risk for mesh migration into the defect, especially when some specific points for mesh fixation are not taken into account [21][22][23].…”

Section: Materials Reduced (Or Lightweight Large Pore) Meshesmentioning

confidence: 99%

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Miserez

Peeters

Aufenacker

et al. 2014

Hernia

359

226

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Purpose: In 2009, the European Hernia Society published the EHS Guidelines for the Treatment of Inguinal Hernia in Adult Patients. The Guidelines contain recommendations for the treatment of inguinal hernia from diagnosis till aftercare. The guidelines expired January 1, 2012. To keep them updated, a revision of the guidelines was planned including new level 1 evidence. Methods: The original Oxford Centre for Evidence-Based Medicine ranking was used. All relevant level 1A and level 1B literature from May 2008 to June 2010 was searched (Medline and Cochrane) by the Working Group members. All chapters were attributed to the two responsible authors in the initial guidelines document. One new chapter on fixation techniques was added. The quality was assessed by the Working Group members during a 2-day meeting and the data were analysed, especially with respect to any change in the level and/or text of any of the conclusions or recommendations of the initial guidelines. In the end, all relevant references published until January 1, 2013 were included. The final text was approved by all Working Group members. Results: For the following topics, the conclusions and/or recommendations have been changed: indications for treatment, treatment of inguinal hernia, day surgery, antibiotic prophylaxis, training, postoperative pain control and chronic pain. The addendum contains all current level 1 conclusions, Grade A recommendations and new Grade B recommendations based on new level 1 evidence (with the changes in bold). Conclusions: Despite the fact that the Working Group responsible for it tried to represent most kinds of surgeons treating inguinal hernias, such general guidelines inevitably must be fitted to the daily practice of every individual surgeon treating his/her patients. There is no doubt that the future of guideline implementation will strongly depend on the development of easy to use decision support algorithms tailored to the individual patient and on evaluating the effect of guideline implementation on surgical outcome. At the 35th International Congress of the EHS in Gdansk, Poland (May 12-15, 2013), it was decided that the EHS, IEHS and EAES will collaborate from now on with the final goal to publish new joint guidelines, most likely in 2015

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Section: Materials Reduced (Or Lightweight Large Pore) Meshesmentioning

confidence: 99%

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Miserez

Peeters

Aufenacker

et al. 2014

Hernia

359

226

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“…Previous studies have noted higher recurrence rates when the lightweight meshes were used, even reaching more than five per cent as in a study conducted by O'Dwyer et al,[20]Part of the study was to assess the recurrence rate in cases of both meshes. The follow-up period of 12 months should be extended to observe the tendency in the following years.…”

Section: Discussionmentioning

confidence: 99%

“…[20]It is now believed that most of these symptoms are related to the type of material used as mesh for the repair rather than the technique employed. [21]In the past decade, with the introduction of mesh repair for groin hernia the incidence of recurrence following the procedure was found lower than 3% in most studies.…”

mentioning

confidence: 99%

Polyglactine/Polypropylene Mesh vs. Propylene Mesh: Is there a need for newer prosthesis in inguinal hernia?

Khan

Bangash

Sadiq

et al. 2010

Saudi J Gastroenterol

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Background/Aim:To compare outcomes of light and heavy weight mesh for repair of inguinal hernia.Materials and Methods:This study was conducted at the Department of Surgery; Lady Reading Hospital, Peshawar from January 1, 2007 to December 31, 2008. Patients were divided into two groups based on the type of mesh implanted for inguinal hernia repair. Group 1 included patients in whom light weight composite (VyproII®) mesh is implanted: Group 2 included patients in whom polypropylene (ProleneR) mesh is implanted. Data concerning the complications and post operative pain in the perioperative and postoperative period were collected and analyzed. Categorical data were presented as percentages with 95% confidence intervals and compared using a χ2test and P<0.05 were considered significant.Results:Following allocation and exclusion of violating cases, 111 patients in group 1 and 138 patients in group 2 were analyzed. The mean age in group 1 was 38.20 ± 13.34 years and in group 2 was 39.55 ± 13.70 (P = 0.434). In group 1, hematoma formation was observed in four cases (3.6%), while it was observed in six cases (4.2%) in group 2 (P = 0.766). During the entire study, ten patients in all developed urinary retention, three of which required transient catheterization. One year post operation, there was a recurrence in only five cases overall, while only two patients complained of pain (P = 0.826).Conclusion:The frequency of postoperative pain and complications in patients was similar in both groups.

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“…The lack of and "ideal" mesh lead to the development of a series of composed meshes, mixing different types of materials [1][2][3][4] . The main advantage of the composed meshes it is the possibility of intraperitoneal placement, with minimal adhesion formation.…”

Section: ■ Introductionmentioning

confidence: 99%

“…The macroscopic quantification, due to the direct observation of the adhesions, makes studies in human beings ethically prohibitive, once a new surgical procedure would be necessary, allowing the formation of new adhesions. Therefore, studies performed in humans have the bias of being performed under the treatment of complications caused by initial repairs, such as hernia recurrence or intestinal obstruction caused by adhesions 3,4,6,7 .…”

mentioning

confidence: 99%

Comparative study of intraperitoneal adhesions related to light-weight polypropylene mesh and type I polymerized and purified bovine collagen coated light-weight polypropylene mesh in rabbits

Garcia

Santos²,

Nunes

et al. 2017

Acta Cir. Bras.

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Comparative study of intraperitoneal adhesions related to light-weight polypropylene mesh and type I polymerized and purified bovine collagen coated light-weight polypropylene mesh in rabbits 1 2-Experimental SurgeryActa Cir Bras. 2017;32(11):903-912 AbstractPurpose: To compare the effectiveness of light-weight polypropylene mesh coated with polymerized and purified bovine type I collagen (Surgidry HNB) in the treatment of abdominal wall defect and the degree of adhesion formation. Methods: Two types of polypropylene mesh were implanted after creation of defect measuring 6.0cm X 5.5cm in the anterior abdominal wall of 32 male New Zealand breed rabbits, divided in two groups (n = 32): (1) light-weigh macroporous polypropylene, (2) type I polymerized and purified bovine collagen coated light-weigh macroporous polypropylene. These animals were further accessed for adhesions, histological evaluation of inflammation and wall's thickness. Results:The percentage of the area adhered in group 1 (62.31 ± 16.6) was higher compared to group 2 (22.19 ± 14.57) (p <0.05). There was an association between the percentage of the covered area by adhesions and the type of adhesion, toughness and the scores obtained by the adhesion score by correlation analysis (p <0.05). There was no difference between the groups in any variables in relation to the degree of inflammation. Conclusion:The purified type I bovine collagen coated light-weigh polypropylene mesh showed to be effective in the repair of abdominal wall defects and reducing adhesion formation. 903Comparative study of intraperitoneal adhesions related to light-weight polypropylene mesh and type I polymerized and purified bovine collagen coated light-weight polypropylene mesh in rabbits Garcia DPC et al. Acta Cir Bras. 2017;32(11):903-912

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Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair

Abstract: Use of lightweight mesh was associated with less chronic pain but an increase in hernia recurrence after inguinal hernia repair. The latter may be related to technical factors associated with fixation of such meshes rather than any inherent defect in the mesh.

Cited by 308 publications

References 11 publications

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

Polyglactine/Polypropylene Mesh vs. Propylene Mesh: Is there a need for newer prosthesis in inguinal hernia?

Comparative study of intraperitoneal adhesions related to light-weight polypropylene mesh and type I polymerized and purified bovine collagen coated light-weight polypropylene mesh in rabbits

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