Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study

Jason Joe Baker; Stina Öberg; Kristoffer Andresen; Frederik Helgstrand; Jacob Rosenberg

doi:10.1007/s00423-018-1681-2

Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study

Jason Joe Baker, Stina Öberg, Kristoffer Andresen, Frederik Helgstrand, Jacob Rosenberg

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Langenbeck's Archives of Surgery
Volume	403
Issue number	4
Pages (from-to)	521-527
Number of pages	7
ISSN	1435-2443
DOIs	https://doi.org/10.1007/s00423-018-1681-2
Publication status	Published - 1 Jun 2018

Keywords

Aged
Cohort Studies
Denmark
Female
Hernia, Ventral/surgery
Herniorrhaphy/adverse effects
Humans
Kaplan-Meier Estimate
Laparoscopy/adverse effects
Male
Middle Aged
Postoperative Complications/epidemiology
Proportional Hazards Models
Recurrence
Reoperation
Surgical Mesh
Suture Techniques
Sutures

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10.1007/s00423-018-1681-2

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Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair : a nationwide cohort study. / Baker, Jason Joe; Öberg, Stina; Andresen, Kristoffer et al.

In: Langenbeck's Archives of Surgery, Vol. 403, No. 4, 01.06.2018, p. 521-527.

Research output: Contribution to journal › Journal article › Research › peer-review

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title = "Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study",

abstract = "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.",

keywords = "Aged, Cohort Studies, Denmark, Female, Hernia, Ventral/surgery, Herniorrhaphy/adverse effects, Humans, Kaplan-Meier Estimate, Laparoscopy/adverse effects, Male, Middle Aged, Postoperative Complications/epidemiology, Proportional Hazards Models, Recurrence, Reoperation, Surgical Mesh, Suture Techniques, Sutures",

author = "Baker, {Jason Joe} and Stina {\"O}berg and Kristoffer Andresen and Frederik Helgstrand and Jacob Rosenberg",

year = "2018",

month = jun,

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doi = "10.1007/s00423-018-1681-2",

language = "English",

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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 -

Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study

Abstract

Keywords

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