Self-Gripping Meshes for Lichtenstein Repair. Do We Need Additional Suture Fixation?

Köhler, Gernot, Lechner, Michael, Mayer, Franz, Köckerling, Ferdinand, Schrittwieser, Rudolf, Fortelny, René H, Adolf, Daniela and Emmanuel, Klaus (2016) Self-Gripping Meshes for Lichtenstein Repair. Do We Need Additional Suture Fixation? World journal of surgery, 40 (2). pp. 298-308. ISSN 1432-2323

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BACKGROUND The Lichtenstein repair is a frequently used treatment of inguinal hernias. In recent years, there has been an increasing tendency to apply self-gripping meshes (s.g). In many cases, additional suture of the mesh is carried out; however, it is uncertain what the benefits or potential risks of this actually are. METHODS The evaluation was undertaken on the basis of the Herniamed register, and covered all unilateral Lichtenstein operations between 01.09.2009 up to 30.09.2013. The analysis only included patients with whom s.g. meshes with resorbable micro hooks had been used (Progrip(®), Covidien) and who had undergone a full 1-year follow-up examination (80.15 %). RESULTS In total, 2095 patients were suitable for analysis, of which 816 (38.95 %) cases received an additional suture fixation (Fix). With increasing hernia size, more frequent fixation took place (29.97 % of hernias <1.5 cm vs. 46.65 % of hernias >3 cm, p < 0.001). The recurrence rates 1 year after surgery did not show any significant differences (Fix. 0.86 % vs. No Fix. 1.17 %; p = 0.661) with and without fixation, even when being adjusted for covariables. Likewise, no differences were noted in terms of postoperative complications (Fix. 5.15 % vs. No Fix. 5.08 %; p = 1.0). In addition, the numbers of patients needing to be treated after 1 year for chronic pain were also comparable (Fix. 2.33 % vs. No Fix. 2.97 %; p = 0.411). CONCLUSION Within the group that did not have additional suture fixation of self-gripping meshes (No Fix.), the length of operations was on average 8 min shorter (p < 0.001). No differences could be observed in terms of postoperative complications, treatment requiring chronic pain and recurrence rates.
Item Type: Fachpublikation (peer reviewed)
Divisions: Ordensklinikum Linz Barmherzige Schwestern > Allgemeinchirurgie mit Viszeralchirurgie
Depositing User: Judith Brandstetter
Date Deposited: 08 Mar 2021 09:01
Last Modified: 08 Mar 2021 09:01

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