scholarly journals Laparoscopic approach to ventral incisional hernia: absorbable or non-absorbable tacks? —a meta-analysis

2018 ◽  
Vol 2 ◽  
pp. 63-63
Author(s):  
Mirko Barone ◽  
Paolo Raimondi ◽  
Francesco Caldaralo ◽  
Annadomenica Cichella ◽  
Mouner Tannous ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Meta Analysis ◽  
Laparoscopic Approach ◽  
Ventral Incisional Hernia ◽  
Absorbable Tacks

Chemotherapy and Abdominal Wall Closure Technique Increase the Probability of Postoperative Ventral Incisional Hernia in Patients With Colon Cancer

2021 ◽  
pp. 000313482110111
Author(s):  
David A. Santos ◽  
Liangliang Zhang ◽  
Kim-Anh Do ◽  
Brian K. Bednarski ◽  
Celia Robinson Ledet ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Incisional Hernia ◽  
Abdominal Wall ◽  
Suture Technique ◽  
Abdominal Wall Closure ◽  
Clinical Predictors ◽  
Closure Technique ◽  
Ventral Incisional Hernia

Background Chemotherapy is associated with postoperative ventral incisional hernia (PVIH) after right hemicolectomy (RHC) for colon cancer, and abdominal wall closure technique may affect PVIH. We sought to identify clinical predictors of PVIH. Methods We retrospectively analyzed patients who underwent RHC for colon cancer from 2008-2018 and later developed PVIH. Time to PVIH was analyzed with Kaplan-Meier analysis, clinical predictors were identified with multivariable Cox proportional hazards modeling, and the probability of PVIH given chemotherapy and the suture technique was estimated with Bayesian analysis. Results We identified 399 patients (209 no adjuvant chemotherapy and 190 adjuvant chemotherapy), with an overall PVIH rate of 38%. The 5-year PVIH rate was 55% for adjuvant chemotherapy, compared with 38% for none (log-rank P < .05). Adjuvant chemotherapy (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.18-2.31, P < .01), age (HR .99, 95% CI .97-1.00, P < .01), body mass index (HR 1.02, 95% CI 1.00-1.04, P < .01), and neoadjuvant chemotherapy (HR 1.92, 95% CI 1.21-3.00, P < .01) were independently associated with PVIH. Postoperative ventral incisional hernia was more common overall in patients who received adjuvant chemotherapy (46% compared with 30%, P < .01). In patients who received adjuvant chemotherapy, the probability of PVIH for incision closure with #1 running looped polydioxanone was 42%, compared with 59% for incision closure with #0 single interrupted polyglactin 910. Discussion Exposure to chemotherapy increases the probability of PVIH after RHC, and non–short stitch incision closure further increases this probability, more so than age or body mass index. The suture technique deserves further study as a modifiable factor in this high-risk population.

scholarly journals Prevention of incisional hernia at the site of stoma closure with different reinforcing mesh types: a systematic review and meta-analysis

Hernia ◽  
2021 ◽  
Author(s):  
Roberto Peltrini ◽  
Nicola Imperatore ◽  
Gaia Altieri ◽  
Simone Castiglioni ◽  
Maria Michela Di Nuzzo ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Operative Time ◽  
Meta Analysis ◽  
Short Term ◽  
Mesh Group ◽  
Closure Technique ◽  
Mesh Placement ◽  
Mesh Reinforcement ◽  
Significant Difference ◽  
Significant Superiority

Abstract Purpose To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses used. Methods A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Cochrane databases was conducted to identify comparative studies until September 2020. A meta-analysis of postoperative outcomes and a network meta-analysis for a multiple comparison of the prostheses with each other were performed. Results Seven studies were included in the analysis (78.4% ileostomy and 21.6% colostomy) with a total of 1716 patients with (n = 684) or without (n = 1032) mesh. Mesh placement was associated with lower risk of SSIH (7.8%vs18.1%, OR0.266,95% CI 0.123–0.577, p < 0.001) than no mesh procedures but also with a longer operative time (SMD 0.941, 95% CI 0.462–1.421, p < 0.001). There was no statistically significant difference in terms of Surgical Site infection (11.5% vs 11.1%, OR 1.074, 95% CI 0.78–1.48, p = 0.66), seroma formation (4.4% vs 7.1%, OR 1.052, 95% CI 0.64–1.73, p = 0.84), anastomotic leakage (3.7% vs 2.7%, OR 1.598, 95% CI 0.846–3.019, p = 0.149) and length of stay (SMD − 0.579,95% CI − 1.261 to 0.102, p = 0.096) between mesh and no mesh groups. Use of prosthesis was associated with a significant lower need for a reoperation than no mesh group (8.1% vs 12.1%, OR 0.332, 95% CI 0.119–0.930, p = 0.036). Incidence of seroma is lower with biologic than polypropylene meshes but they showed a trend towards poor results compared with polypropylene or biosynthetic meshes. Conclusion Despite longer operative time, mesh prophylactic reinforcement at the site of stoma seems a safe and effective procedure with lower incidence of SSIH, need for reoperation and comparable short-term outcomes than standard closure technique. A significant superiority of a specific mesh type was not identified.

Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery—A Systematic Review and Meta-Analysis

2016 ◽  
Vol 40 (10) ◽  
pp. 2319-2330 ◽  
Author(s):  
Julia B. Kössler-Ebs ◽  
Kathrin Grummich ◽  
Katrin Jensen ◽  
Felix J. Hüttner ◽  
Beat Müller-Stich ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Incisional Hernia ◽  
Meta Analysis ◽  
Open Abdominal Surgery

An evidence map and synthesis review with meta-analysis on the risk of incisional hernia in colorectal surgery with standard closure

Hernia ◽  
2022 ◽  
Author(s):  
C. Stabilini ◽  
M.A. Garcia-Urena ◽  
F. Berrevoet ◽  
D. Cuccurullo ◽  
S. Capoccia Giovannini ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Incisional Hernia ◽  
Meta Analysis ◽  
Evidence Map
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