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Published in: Langenbeck's Archives of Surgery 4/2018

01-06-2018 | ORIGINAL ARTICLE

Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study

Authors: Jason Joe Baker, Stina Öberg, Kristoffer Andresen, Frederik Helgstrand, Jacob Rosenberg

Published in: Langenbeck's Archives of Surgery | Issue 4/2018

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Abstract

Background

There are various ways of fixating an intraperitoneal onlay mesh during a laparoscopic ventral hernia repair. The risk of complications is high, and around 22% of the hernias will recur within 3.5 years. The aim of this study was to assess if sutures in addition to tack fixation would reduce the re-operation rate for recurrence compared with permanent tacks without sutures.

Methods

This study was based on the data from the nationwide Danish Ventral Hernia Database, which contains information of ventral hernia repairs from all hospitals in Denmark. Two different cohorts of patients were created and analyzed separately. The primary outcome was the re-operation rate for recurrence, analyzed with the Cox regression model and illustrated with a Kaplan-Meier plot adjusted for confounders. The follow-up period was defined as months from the first hernia repair to re-operation for recurrence, death, or the 1st of June 2017.

Results

The first cohort included 598 patients with absorbable sutures and tacks compared with 1793 patients with permanent tacks. The second cohort included 72 patients with permanent sutures and tacks compared with 216 patients with permanent tacks. In the suture groups, the tack material was either permanent or absorbable. When adjusting for possible confounders in the Cox regression model, there were no significant differences in the re-operation rate for recurrence between the groups in the two cohorts.

Conclusion

Adding sutures, either absorbable or permanent, to tack fixation of mesh during laparoscopic ventral hernia repair did not influence the re-operation rates for recurrence.
Literature
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go back to reference Helgstrand F, Tenma J, Rosenberg J, Kehlet H, Bisgaard T (2013) High agreement between the Danish Ventral Hernia Database and hospital files. Dan Med J 60:A4708PubMed Helgstrand F, Tenma J, Rosenberg J, Kehlet H, Bisgaard T (2013) High agreement between the Danish Ventral Hernia Database and hospital files. Dan Med J 60:A4708PubMed
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go back to reference Fletcher RH, Fletcher S, Fletcher GS (2014) Risk: looking backwards. In: Clinical epidemiology, the essentials, 5th edn. Lippincott Williams & Wilkins, Philadelphia, p 84 Fletcher RH, Fletcher S, Fletcher GS (2014) Risk: looking backwards. In: Clinical epidemiology, the essentials, 5th edn. Lippincott Williams & Wilkins, Philadelphia, p 84
Metadata
Title
Adding sutures to tack fixation of mesh does not lower the re-operation rate after laparoscopic ventral hernia repair: a nationwide cohort study
Authors
Jason Joe Baker
Stina Öberg
Kristoffer Andresen
Frederik Helgstrand
Jacob Rosenberg
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 4/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-018-1681-2

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