Evaluating the Impact of Technique and Mesh Type in Complicated Ventral Hernia Repair: A Prospective Randomized Multicenter Controlled Trial

Bochicchio, Grant V.; García, Alvaro D.; Kaufman, Jarrod P.; Zhang, Qiao; Horn, Christopher B.; Bochicchio, Kelly; Sato, Bryan; Reese, Stacey; Ilahi, Obeid

doi:10.1016/j.jamcollsurg.2019.01.012

Cited by 9 publications

(13 citation statements)

References 28 publications

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“…3). Three MVR studies, 4 PSA studies and 1 RCT reporting late SSI data did not produce consistent evidence on risk factors for SSI [64, 70, 72, 82, 91, 100, 102, 124]. .…”

Section: Resultsmentioning

confidence: 99%

“…The pooled late seroma rate was 14.1% (95% CI: 10.9–17.2%; study‐specific range:4.3–51.4%). An RCT and 2 PSA studies did not offer consistent evidence of risk factors for late seromas [64, 78, 102].…”

Section: Resultsmentioning

confidence: 99%

“…An RCT Fig. 3 Forest plot, meta-analysis of late SSIs and 2 PSA studies did not offer consistent evidence of risk factors for late seromas [64,78,102].…”

Section: Late Outcomesmentioning

confidence: 94%

“…3). Three MVR studies, 4 PSA studies and 1 RCT reporting late SSI data did not produce consistent evidence on risk factors for SSI [64,70,72,82,91,100,102,124].. Late seromas were reported in 24 studies (aggregate n = 3,079). The pooled late seroma rate was 14.1% (95% CI: 10.9-17.2%; study-specific range:4.3-51.4%).…”

Section: Late Outcomesmentioning

confidence: 95%

“…Fifteen studies conducted MVR analysis in an exploratory fashion[64,65,67,70,73,74,82,83,85,86,88,90,93,99,100,103,107,108,113,119,123].…”

mentioning

confidence: 99%

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Biologic Mesh in Surgery: A Comprehensive Review and Meta‐Analysis of Selected Outcomes in 51 Studies and 6079 Patients

2021

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Background In recent decades, biologic mesh (BM) has become an important adjunct to surgical practice. Recent evidence‐based clinical applications of BM include but are not limited to: reconstruction of abdominal wall defects; breast reconstruction; face, head and neck surgery; periodontal surgery; other hernia repairs (diaphragmatic, hiatal/paraesophageal, inguinal and perineal); hand surgery; and shoulder arthroplasty. Prior systematic reviews of BM in complex abdominal wall hernia repair had several shortcomings that our comprehensive review seeks to address, including exclusion of laparoscopic repair, assessment of risk of bias, use of an acceptable meta‐analytic method and review of risk factors identified in multivariable regression analyses. Materials and methods We sought articles of BM for open ventral hernia repair reporting on early complications, late complications or recurrences and included minimum of 50. We used the quality in prognostic studies risk of bias assessment tool. Random effects meta‐analysis was applied. Results This comprehensive review selected 62 articles from 51 studies that included 6,079 patients. Meta‐analytic pooling found that early complications are present in about 50%, surgical site occurrences (SSOs) in 37%, surgical site infections (SSIs) in 18%, reoperation in 7%, readmission in 20% and mortality in 3%. Meta‐analytic estimates of late outcomes included overall complications (42%), SSOs (40%) and SSIs (22%). Specific SSOs included seroma (14%), hematoma (4%), abscess (10%), necrosis (5%), dehiscence (8%) and fistula formation (5%). Reoperation occurred in about 17%, mesh explantation in 9% and recurrence in 36%. Conclusion Estimates of nearly all outcomes from individual studies were highly heterogeneous and sensitivity analyses and meta‐regressions generally failed to explain this heterogeneity. Recurrence is the only outcome for which there are consistent findings for risk factors. Bridge placement of BM is associated with higher risk of recurrence. Prior hernia repair, history of reintervention and history of mesh removal were also risk factors for increased recurrence.

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“…3). Three MVR studies, 4 PSA studies and 1 RCT reporting late SSI data did not produce consistent evidence on risk factors for SSI [64, 70, 72, 82, 91, 100, 102, 124]. .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…An RCT Fig. 3 Forest plot, meta-analysis of late SSIs and 2 PSA studies did not offer consistent evidence of risk factors for late seromas [64,78,102].…”

Section: Late Outcomesmentioning

confidence: 94%

Section: Late Outcomesmentioning

confidence: 95%

“…Fifteen studies conducted MVR analysis in an exploratory fashion[64,65,67,70,73,74,82,83,85,86,88,90,93,99,100,103,107,108,113,119,123].…”

mentioning

confidence: 99%

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Biologic Mesh in Surgery: A Comprehensive Review and Meta‐Analysis of Selected Outcomes in 51 Studies and 6079 Patients

2021

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Scientific Surgery

2019

British Journal of Surgery

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Ponds FA, Fockens P, Lei A, Neuhaus H, Beyna T, Kandler J et al. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia. A randomized clinical trial. JAMA 2019; 322: 134-144. Ponten J, Leclercq WKG, Lettinga T, Heemskerk J, Konsten JLM, Bouvy ND et al. Mesh OR Patch for Hernia on Epigastric and Umbilical Sites (MORPHEUS-Trial). The Complete Two-year Follow-up. Ann Surg 2019; 270: 33-37.In this study of 352 patients there were more complications after repair with a ventral patch than flat prolene mesh (P = 0⋅04), but hernia recurrence rates were similar.

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