Mesh fixation to fascia during incisional hernia repair results in increased prevalence of pain at long-term follow up: a multicenter propensity score matched prospective observational study

Kohler, Andreas; Lavanchy, Joël L.; Gasser, Rahel; Wyss, Roland; Nowak, Lars; Scheiwiller, Andreas; Hämmerli, Peter; Candinas, Daniel; Beldi, Guido (2021). Mesh fixation to fascia during incisional hernia repair results in increased prevalence of pain at long-term follow up: a multicenter propensity score matched prospective observational study (In Press). Surgical endoscopy Springer-Verlag 10.1007/s00464-021-08355-8

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Background: Patient-reported outcomes such as postoperative pain are critical for the evaluation of outcomes after incisional hernia repair. The aim of this study is to determine the long-term impact of mesh fixation on postoperative pain in patients operated by open and laparoscopic technique.

Methods: A multicenter prospective observational cohort study was conducted from September 2011 until March 2016 in nine hospitals across Switzerland. Patients undergoing elective incisional hernia repair were included in this study and stratified by either laparoscopic or open surgical technique. Propensity score matching was applied to balance the differences in baseline characteristics between the treatment groups. Clinical follow-up was conducted 3, 12 and 36 months postoperatively to detect hernia recurrence, postoperative pain and complications.

Results: Three-hundred-sixty-one patients were included into the study. No significant differences in hernia recurrence and pain at 3, 12 and 36 months postoperatively were observed when comparing the laparoscopic with the open treatment group. Mesh fixation by sutures to fascia versus other mesh fixation led to significantly more pain at 36 months postoperatively (32.8% vs 15.7%, p = 0.025).

Conclusions: At long-term follow-up, no difference in pain was identified between open and laparoscopic incisional hernia repair. Mesh fixation by sutures to fascia was identified to be associated with increased pain 36 months after surgery. Omitting mesh fixation by sutures to the fascia may reduce long-term postoperative pain after hernia repair.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Kohler, Andreas; Lavanchy, Joël Lukas; Candinas, Daniel and Beldi, Guido

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0930-2794

Publisher:

Springer-Verlag

Language:

English

Submitter:

Joël Lukas Lavanchy

Date Deposited:

19 Apr 2021 11:36

Last Modified:

20 Apr 2021 01:34

Publisher DOI:

10.1007/s00464-021-08355-8

PubMed ID:

33620567

BORIS DOI:

10.7892/boris.153604

URI:

https://boris.unibe.ch/id/eprint/153604

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