TY - JOUR
T1 - Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair
T2 - a nationwide cohort study
AU - Baker, Jason Joe
AU - Öberg, Stina
AU - Andresen, Kristoffer
AU - Helgstrand, Frederik
AU - Rosenberg, Jacob
PY - 2018/6/1
Y1 - 2018/6/1
N2 - BACKGROUND: There are various ways of fixating an intraperitoneal onlay mesh during a laparoscopic ventral hernia repair. The risk of complications is high, and around 22% of the hernias will recur within 3.5 years. The aim of this study was to assess if sutures in addition to tack fixation would reduce the re-operation rate for recurrence compared with permanent tacks without sutures.METHODS: This study was based on the data from the nationwide Danish Ventral Hernia Database, which contains information of ventral hernia repairs from all hospitals in Denmark. Two different cohorts of patients were created and analyzed separately. The primary outcome was the re-operation rate for recurrence, analyzed with the Cox regression model and illustrated with a Kaplan-Meier plot adjusted for confounders. The follow-up period was defined as months from the first hernia repair to re-operation for recurrence, death, or the 1st of June 2017.RESULTS: The first cohort included 598 patients with absorbable sutures and tacks compared with 1793 patients with permanent tacks. The second cohort included 72 patients with permanent sutures and tacks compared with 216 patients with permanent tacks. In the suture groups, the tack material was either permanent or absorbable. When adjusting for possible confounders in the Cox regression model, there were no significant differences in the re-operation rate for recurrence between the groups in the two cohorts.CONCLUSION: Adding sutures, either absorbable or permanent, to tack fixation of mesh during laparoscopic ventral hernia repair did not influence the re-operation rates for recurrence.
AB - BACKGROUND: There are various ways of fixating an intraperitoneal onlay mesh during a laparoscopic ventral hernia repair. The risk of complications is high, and around 22% of the hernias will recur within 3.5 years. The aim of this study was to assess if sutures in addition to tack fixation would reduce the re-operation rate for recurrence compared with permanent tacks without sutures.METHODS: This study was based on the data from the nationwide Danish Ventral Hernia Database, which contains information of ventral hernia repairs from all hospitals in Denmark. Two different cohorts of patients were created and analyzed separately. The primary outcome was the re-operation rate for recurrence, analyzed with the Cox regression model and illustrated with a Kaplan-Meier plot adjusted for confounders. The follow-up period was defined as months from the first hernia repair to re-operation for recurrence, death, or the 1st of June 2017.RESULTS: The first cohort included 598 patients with absorbable sutures and tacks compared with 1793 patients with permanent tacks. The second cohort included 72 patients with permanent sutures and tacks compared with 216 patients with permanent tacks. In the suture groups, the tack material was either permanent or absorbable. When adjusting for possible confounders in the Cox regression model, there were no significant differences in the re-operation rate for recurrence between the groups in the two cohorts.CONCLUSION: Adding sutures, either absorbable or permanent, to tack fixation of mesh during laparoscopic ventral hernia repair did not influence the re-operation rates for recurrence.
KW - Aged
KW - Cohort Studies
KW - Denmark
KW - Female
KW - Hernia, Ventral/surgery
KW - Herniorrhaphy/adverse effects
KW - Humans
KW - Kaplan-Meier Estimate
KW - Laparoscopy/adverse effects
KW - Male
KW - Middle Aged
KW - Postoperative Complications/epidemiology
KW - Proportional Hazards Models
KW - Recurrence
KW - Reoperation
KW - Surgical Mesh
KW - Suture Techniques
KW - Sutures
U2 - 10.1007/s00423-018-1681-2
DO - 10.1007/s00423-018-1681-2
M3 - Journal article
C2 - 29785453
SN - 1435-2443
VL - 403
SP - 521
EP - 527
JO - Langenbecks Archives of Surgery
JF - Langenbecks Archives of Surgery
IS - 4
ER -