Long-term outcomes after contaminated complex abdominal wall reconstruction
| Autor: | F. E. E. de Vries, Jeroen J. M. Claessen, Pieter J. Tanis, Marja A. Boermeester, Yasuko Maeda, C. A. Leo, Miryam C. Obdeijn, O. van Ruler, J. D. Hodgkinson, Oren Lapid, Janindra Warusavitarne, George B. Hanna, Carolynne J. Vaizey, W. A. Bemelman, J. Constantinides |
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| Přispěvatelé: | AGEM - Digestive immunity, Plastic, Reconstructive and Hand Surgery, ACS - Diabetes & metabolism, AMS - Restoration & Development, AMS - Amsterdam Movement Sciences, Surgery, AGEM - Re-generation and cancer of the digestive system, AMS - Rehabilitation & Development |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Surgical Wound Outcomes 030230 surgery 03 medical and health sciences 0302 clinical medicine Postoperative Complications Contamination Recurrence Complex Long term outcomes medicine Humans Surgical Wound Infection Hernia Prospective Studies Patient group Herniorrhaphy Aged Retrospective Studies Mesh business.industry Abdominal Wall Abdominal wall reconstruction Retrospective cohort study Abdominal wall repair Abdominal Wound Closure Techniques Middle Aged Plastic Surgery Procedures Surgical Mesh medicine.disease Hernia repair Hernia Ventral Surgery Treatment Outcome 030220 oncology & carcinogenesis Wounds and Injuries Female Original Article business Abdominal surgery Follow-Up Studies |
| Zdroj: | Hernia, 24(3), 459-468. Springer Paris Hernia |
| ISSN: | 1265-4906 |
| Popis: | Purpose Complex abdominal wall repair (CAWR) in a contaminated operative field is a challenge. Available literature regarding long-term outcomes of CAWR comprises studies that often have small numbers and heterogeneous patient populations. This study aims to assess long-term outcomes of modified-ventral hernia working group (VHWG) grade 3 repairs. Because the relevance of hernia recurrence (HR) as the primary outcome for this patient group is contentious, the need for further hernia surgery (FHS) was also assessed in relation to long-term survival. Methods A retrospective cohort study with a single prospective follow-up time-point nested in a consecutive series of patients undergoing CAWR in two European national intestinal failure centers. Results In long-term analysis, 266 modified VHWG grade 3 procedures were included. The overall HR rate was 32.3%. The HR rates for non-crosslinked biologic meshes and synthetic meshes when fascial closure was achieved were 20.3% and 30.6%, respectively. The rates of FHS were 7.2% and 16.7%, and occurred only within the first 3 years. Bridged repairs showed poorer results (fascial closure 22.9% hernia recurrence vs bridged 57.1% recurrence). Overall survival was relatively good with 80% en 70% of the patients still alive after 5 and 10 years, respectively. In total 86.6% of the patients remained free of FHS. Conclusions In this study of contaminated CAWR, non-crosslinked biologic mesh shows better results than synthetic mesh. Bridging repairs with no posterior and/or anterior fascial closure have a higher recurrence rate. The overall survival was good and the majority of patients remained free of additional hernia surgery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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