Fibrin sealant for mesh fixation in laparoscopic groin hernia repair does not increase long-term recurrence

Fenger, Andreas Qwist; Helvind, Neel Maria; Pommergaard, Hans‐Christian; Burcharth, Jakob; Rosenberg, Jacob

doi:10.1007/s00464-015-4280-0

Cited by 16 publications

(6 citation statements)

References 27 publications

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“…Mesh fixation should be used in TAPP, in particular, for defects of more than 3 cm and for medial inguinal hernia [53]. Similarly, a register study of the Danish Hernia Database confirmed the equivalence of tacker and glue mesh fixation in TAPP [54].…”

Section: Resultsmentioning

confidence: 99%

Surgical risk factors for recurrence in inguinal hernia repair – a review of the literature

Niebuhr¹,

Köckerling

2017

Innovative Surgical Sciences

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Despite all the progress made in inguinal hernia surgery driven by the development of meshes and laparoendoscopic operative techniques, the proportion of recurrent inguinal hernias is still from 12% to 13%. Recurrences can present very soon after primary inguinal hernia repair generally because of technical failure. However, they can also develop much later after the primary operation probably due to patient-specific factors. Supported by evidence-based data, this review presents the surgical risk factors for recurrent inguinal hernia after the primary operation. The following factors are implicated here: choice of operative technique and mesh, mesh fixation technique, mesh size, management of medial and lateral hernia sac, sliding hernia, lipoma in the inguinal canal, operating time, type of anesthesia, participation in a register database, femoral hernia, postoperative complications, as well as the center and surgeon volume. If these surgical risk factors are taken into account when performing primary inguinal hernia repair, a good outcome can be expected for the patient. Therefore, they should definitely be observed.

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Section: Resultsmentioning

confidence: 99%

Surgical risk factors for recurrence in inguinal hernia repair – a review of the literature

Niebuhr¹,

Köckerling

2017

Innovative Surgical Sciences

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“…The results of six RCTs 569 , 571 , 574 , 576 – 578 and three case control trials 586 , 588 , 589 confirmed this finding. In addition to the meta-analyses and RCTs, a recently published study from the Danish Hernia Database included 1535 patients and detected no significant difference using Cox regression analysis [hazard ratio 0.8; 95% CI (0.5–1.2)] 599 in long-term reoperation rates and clinical recurrences (median follow-up time of 31 months) in patients undergoing TAPP IH repair with mesh fixation by fibrin sealant compared to tacks.…”

Section: Mesh Fixationmentioning

confidence: 99%

International guidelines for groin hernia management

Simons¹,

Śmietański²,

Bonjer³

et al. 2018

Hernia

1,557

712

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IntroductionWorldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery.MethodsAn expert group of international surgeons (the HerniaSurge Group) and one anesthesiologist pain expert was formed. The group consisted of members from all continents with specific experience in hernia-related research. Care was taken to include surgeons who perform different types of repair and had preferably performed research on groin hernia surgery. During the Group’s first meeting, evidence-based medicine (EBM) training occurred and 166 key questions (KQ) were formulated. EBM rules were followed in complete literature searches (including a complete search by The Dutch Cochrane database) to January 1, 2015 and to July 1, 2015 for level 1 publications. The articles were scored by teams of two or three according to Oxford, SIGN and Grade methodologies. During five 2-day meetings, results were discussed with the working group members leading to 136 statements and 88 recommendations. Recommendations were graded as “strong” (recommendations) or “weak” (suggestions) and by consensus in some cases upgraded. In the Results and summary section below, the term “should” refers to a recommendation. The AGREE II instrument was used to validate the guidelines. An external review was performed by three international experts. They recommended the guidelines with high scores.Results and summaryThe risk factors for inguinal hernia (IH) include: family history, previous contra-lateral hernia, male gender, age, abnormal collagen metabolism, prostatectomy, and low body mass index. Peri-operative risk factors for recurrence include poor surgical techniques, low surgical volumes, surgical inexperience and local anesthesia. These should be considered when treating IH patients. IH diagnosis can be confirmed by physical examination alone in the vast majority of patients with appropriate signs and symptoms. Rarely, ultrasound is necessary. Less commonly still, a dynamic MRI or CT scan or herniography may be needed. The EHS classification system is suggested to stratify IH patients for tailored treatment, research and audit. Symptomatic groin hernias should be treated surgically. Asymptomatic or minimally symptomatic male IH patients may be managed with “watchful waiting” since their risk of hernia-related emergencies is low. The majority of these individuals will eventually require surgery; therefore, surgical risks and the watchful waiting strategy should be discussed with patients. Surgical treatment s...

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“…In this systematic review, data quality issues were the most commonly reported barriers, followed by the lack of data standards and limited technical capabilities. Although Denmark has a developed health data infrastructure, numerous identified projects described that data quality problems still affect health services, public health and research datasets [38, 79, 86, 98, 119, 143, 149, 151]. This is confirmed by other studies, such as a review on the Danish National Patient Registry (DNRP) where the authors concluded that data incompleteness and heterogeneous validation methods of data limited the research potential of this registry [377].…”

Section: Discussionmentioning

confidence: 87%

Factors influencing harmonized health data collection, sharing and linkage in Denmark and Switzerland: A systematic review

Geneviève

Martani²,

Mallet³

et al. 2019

PLoS ONE

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IntroductionThe digitalization of medicine has led to a considerable growth of heterogeneous health datasets, which could improve healthcare research if integrated into the clinical life cycle. This process requires, amongst other things, the harmonization of these datasets, which is a prerequisite to improve their quality, re-usability and interoperability. However, there is a wide range of factors that either hinder or favor the harmonized collection, sharing and linkage of health data.ObjectiveThis systematic review aims to identify barriers and facilitators to health data harmonization—including data sharing and linkage—by a comparative analysis of studies from Denmark and Switzerland.MethodsPublications from PubMed, Web of Science, EMBASE and CINAHL involving cross-institutional or cross-border collection, sharing or linkage of health data from Denmark or Switzerland were searched to identify the reported barriers and facilitators to data harmonization.ResultsOf the 345 projects included, 240 were single-country and 105 were multinational studies. Regarding national projects, a Swiss study reported on average more barriers and facilitators than a Danish study. Barriers and facilitators of a technical nature were most frequently reported.ConclusionThis systematic review gathered evidence from Denmark and Switzerland on barriers and facilitators concerning data harmonization, sharing and linkage. Barriers and facilitators were strictly interrelated with the national context where projects were carried out. Structural changes, such as legislation implemented at the national level, were mirrored in the projects. This underlines the impact of national strategies in the field of health data. Our findings also suggest that more openness and clarity in the reporting of both barriers and facilitators to data harmonization constitute a key element to promote the successful management of new projects using health data and the implementation of proper policies in this field. Our study findings are thus meaningful beyond these two countries.

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Fibrin sealant for mesh fixation in laparoscopic groin hernia repair does not increase long-term recurrence

Abstract: We found no significant difference in long-term reoperation rates and clinical recurrences in patients undergoing TAPP repair with meshes fixated with fibrin sealant compared with tacks.

Cited by 16 publications

References 27 publications

Surgical risk factors for recurrence in inguinal hernia repair – a review of the literature

Surgical risk factors for recurrence in inguinal hernia repair – a review of the literature

International guidelines for groin hernia management

Factors influencing harmonized health data collection, sharing and linkage in Denmark and Switzerland: A systematic review

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