Home E-Weekly February 7, 2017

Mesh Associated with Fewer Repairs, But More Complications in Hernia Repair

Published: February 6, 2017

MIXED MESSAGE Mesh patients were about 50% less likely to need repairs.

Using mesh in incisional hernia repairs tends to provide significant benefit in the short run, but may be substantially less beneficial over time, according to a study.

Researchers in Denmark found that patients who had non-mesh surgeries were much more likely to need subsequent repairs than patients who had either open or laparoscopic mesh repairs, but that after 5 years, a much higher percentage of the mesh patients had serious complications.

The study covered roughly 3,200 patients who had hernias repaired from 2007 to 2010. Of the 366 (11%) who had non-mesh repairs, 17.1% eventually required repairs. Only 12.3% of those who had open mesh procedures and only 10.6% of those who had laparoscopic mesh procedures needed repairs.

But the 5-year complication rates were 5.6% (open mesh) and 3.7% (laparoscopic mesh), compared with 0.8% for non-mesh. Between 1% and 2% of the mesh-related complications were life-threatening. They included bowel perforation, enterocutaneous fistulas, chronic surgical site infections, hematomas, seromas and bowel obstruction.

The authors note, however, that the non-mesh patients generally had smaller hernia defects than their mesh counterparts. They add that they would expect mesh-related complications to continue to develop over time, but that they still recommend using it.

Jim Burger

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