Massive Incisional Hernia Repair with Parietex: Monocentric Analysis on 500 Cases Treated with a Laparoscopic Approach
| Autor: | Stefano Olmi, Giovanni Cesana, Matteo Uccelli, Francesca Ciccarese, Giorgio Castello, Francesco Caruso |
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| Přispěvatelé: | Caruso, F., Ciccarese, F., Cesana, G., Uccelli, M., Castello, G., Olmi, S. |
| Rok vydání: | 2017 |
| Předmět: |
Male
030230 surgery Severity of Illness Index Postoperative Complications 0302 clinical medicine Recurrence Medicine Postoperative Period Defect size Mortality rate Protack Laparoscopic incisional hernia repair Middle Aged 030220 oncology & carcinogenesis Female Collagen Peritoneum Adult Reoperation medicine.medical_specialty Polyesters Operative Time Retrospective data 03 medical and health sciences Fixation (surgical) Surgical Staplers Humans Incisional Hernia Endopath EMS massive incisional hernia Herniorrhaphy Aged Retrospective Studies business.industry Composite mesh Incisional hernia repair Retrospective cohort study Length of Stay Surgical Mesh Hernia Ventral Surgery Seroma Absorbatack Parietex Feasibility Studies Neuralgia Operative time Laparoscopy business |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 27:388-392 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2016.0623 |
| Popis: | Purpose: The aim of this retrospective study is to demonstrate the safety and feasibility of the laparoscopic technique for treatment of massive incisional hernias (MIHs) and to compare three different fixation devices. Methods: From January 1, 2001, to December 31, 2014, we collected retrospective data from patients with large incisional hernias (IHs). Laparoscopic IH repair is performed by applying a three-dimensional polyester knit structure mesh with a resorbable collagen barrier on peritoneal side (Parietex™ Composite Mesh; Covidien, New Haven, CT). Patients were divided into three groups according to the different fixation devices. The mean follow-up was 19 (12-156) months. Results: The mean defect size was 12.83 cm (10-26 cm) and the mean body mass index was 30.8 kg/m2 (26-39 kg/m2). The EMS stapler™ was used on 260 patients, the Protack® on 210 patients, and the AbsorbaTack™ on 30 patients. The mean operative time was 69.9 minutes (38-130 minutes). Intraoperative morbidity rate was 1.6% (8 cases). Early reoperation rate was 0.2% (1 case). The mean length of hospital stay was 2.3 days (range 2-7 days). Seromas were observed in 20 patients (4.0%) and neuralgia in 10 patients (2.0%). Recurrence was observed in 12 patients (2.4%) with the majority in the absorbable tack group (10%). There were no conversions (0%) to open technique. Conclusions: The laparoscopic approach seems to be safe and appropriate for treatment of MIH. The Parietex composite mesh we used guarantees excellent intraabdominal laparoscopic repair of abdominal wall defects. Absorbatack system seems to give less postoperative neuralgia, but it is related to a high recurrence rate. Protack system seems to give more postoperative neuralgia than the Endopath EMS. In our experience, the best fixation system is the latter. |
| Databáze: | OpenAIRE |
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