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01-07-2019 | Laparotomy | Original Scientific Report

Prophylactic Intraperitoneal Onlay Mesh Following Midline Laparotomy—Long-Term Results of a Randomized Controlled Trial

Authors: Philippe M. Glauser, Philippe Brosi, Benjamin Speich, Samuel A. Käser, Andres Heigl, Robert Rosenberg, Christoph A. Maurer

Published in: World Journal of Surgery | Issue 7/2019

Abstract

Objectives

Incisional hernia, a serious complication after laparotomy, is associated with high morbidity and costs. This trial examines the value of prophylactic intraperitoneal onlay mesh to reduce the risk of incisional hernia after a median follow-up time of 5.3 years.

Methods

We conducted a parallel group, open-label, single center, randomized controlled trial (NCT01003067). After midline incision, the participants were either allocated to abdominal wall closure according to Everett with a PDS-loop running suture reinforced by an intraperitoneal composite mesh strip (Group A) or the same procedure without the additional mesh strip (Group B).

Results

A total of 276 patients were randomized (Group A = 131; Group B = 136). Follow-up data after a median of 5.3 years after surgery were available from 183 patients (Group A = 95; Group B = 88). Incisional hernia was diagnosed in 25/95 (26%) patients in Group A and in 46/88 (52%) patients in Group B (risk ratio 0.52; 95% CI 0.36–0.77; p < 0.001). Eighteen patients with asymptomatic incisional hernia went for watchful waiting instead of hernia repair and remained free of symptoms after of a median follow-up of 5.1 years. Between the second- and fifth-year follow-up period, no complication associated with the mesh could be detected.

Conclusion

The use of a composite mesh in intraperitoneal onlay position significantly reduces the risk of incisional hernia during a 5-year follow-up period.

Trial registration number

Ref. NCT01003067 (clinicaltrials.gov).

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Title: Prophylactic Intraperitoneal Onlay Mesh Following Midline Laparotomy—Long-Term Results of a Randomized Controlled Trial
Authors: Philippe M. Glauser
Philippe Brosi
Benjamin Speich
Samuel A. Käser
Andres Heigl
Robert Rosenberg
Christoph A. Maurer
Publication date: 01-07-2019
Publisher: Springer International Publishing
Keywords: Laparotomy
Laparotomy
Incisional Hernia
Published in: World Journal of Surgery / Issue 7/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-04964-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prophylactic Intraperitoneal Onlay Mesh Following Midline Laparotomy—Long-Term Results of a Randomized Controlled Trial

Abstract

Objectives

Methods

Results

Conclusion

Trial registration number

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Trial registration number

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