Long-term assessment of surgical and quality-of-life outcomes between lightweight and standard (heavyweight) three-dimensional contoured mesh in laparoscopic inguinal hernia repair
| Autor: | Michael R. Arnold, Paul D. Colavita, Eric J. Fromke, Kathleen M. Coakley, Vedra A. Augenstein, Tanu Prasad, B. Todd Heniford, Kent W. Kercher, Steve A. Groene |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Demographics Hernia Inguinal 030230 surgery Body Mass Index 03 medical and health sciences 0302 clinical medicine Postoperative Complications Quality of life medicine Humans Hernia Aged Univariate analysis business.industry Middle Aged Surgical Mesh medicine.disease Surgery Inguinal hernia Surgical mesh Logistic Models 030220 oncology & carcinogenesis Quality of Life Female business |
| Zdroj: | Surgery. 165(4) |
| ISSN: | 1532-7361 |
| Popis: | Mesh weight is a possible contributor to quality-of-life outcomes after inguinal hernia repair. This study compares lightweight mesh versus heavyweight mesh in laparoscopic inguinal hernia repair.A prospective, single-center, hernia-specific database was queried for all adult laparoscopic inguinal hernia repair with three-dimensional contoured mesh (3-D Max, Bard, Inc, New Providence, NJ) from 1999 to June 2016. Demographics and outcomes were analyzed. Quality of life was evaluated preoperatively and after 2 weeks, 4 weeks, 6 months, 12 months, and 24 months, using the Carolinas Comfort Scale. Univariate analysis and multivariate logistic regression were performed.A total of 1,424 laparoscopic inguinal hernia repair were performed with three-dimensional contoured mesh, with 804 patients receiving lightweight mesh and 620 receiving heavyweight mesh. Patients receiving lightweight mesh were somewhat younger (52.6 ± 14.8 years vs 56.3 ± 13.7 years, P.0001), with slightly lower body mass indices (26.4 ± 9.9 vs 27.1 ± 4.3, P.0001). Lightweight mesh was used less often in incarcerated hernias (12.5% vs 16.8%, P = .02). There were a total of 3 surgical site infections. There were no differences in complications between groups except for seroma. Although on univariate analysis, seromas appeared to occur more frequently with heavyweight mesh (21.5% vs 7.9%). On multivariate analysis, heavyweight mesh was not independently associated with seroma formation. Average follow-up was 20 months. Recurrence rates were similar between lightweight mesh and heavyweight mesh (0.7 vs 0.6% P.05). At all points of follow-up (4 week to 3 years), quality-of-life outcomes of discomfort, mesh sensation, and movement limitation scores were similar between lightweight mesh and heavyweight mesh.Contoured lightweight mesh and heavyweight mesh in laparoscopic inguinal hernia repair yield excellent recurrence rates and no difference in postoperative complications or quality of life. Considering the lack of outcome difference with long-term follow-up, heavyweight mesh may be considered for use in laparoscopic inguinal hernia repair patients. |
| Databáze: | OpenAIRE |
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