Open Treatment of Abdominal Wall Hernias: Mesh Repair is Superior to Suture Repair and Onlay Mesh is Better than Sublay Mesh Five-Year Multicentric, Prospective, Randomised Clinical Trial

Baracs, József; D.S., Graciaa; Kelemen, Dezső

doi:10.4172/2161-1076.1000270

Cited by 12 publications

(18 citation statements)

References 32 publications

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“…The mean time duration of surgery for the onlay group was 48.49±0.71 minutes (shortest surgery-35 minutes; longest surgery-62 minutes) and the sublay group was 72.84±0.72 minutes (shortest-60 minutes; longest-90 minutes). Sublay meshplasty takes longer duration to complete than onlay meshplasty due to the extensive dissection of the preperitoneal space with mean time 11,12 The mean pain score for onlay meshplasty on postop day 2, 5 and 7 were 7.91±0.10, 5.01±0.10 and 2.97±0.11 respectively and the mean pain score for sublay meshplasty on postop day 2, 5 and 7 were 6.83±0.06, 3.05±0.04 and 1.05±0.03 respectively with a significant difference between them (p=0.0001). The patients in the onlay group experience higher degree of pain postoperatively when compared with the patients in the sublay group.…”

Section: Discussionmentioning

confidence: 99%

“…Yet the study conducted in Hungary by Baracs et al shows no significant difference in the perception of pain. [11][12][13] The post op wound infection in both the groups were calculated and compared using ASEPSIS scoring system. The mean asepsis score in onlay mesh repair group was 3.60±1.09 and 0.47±0.30 for the sublay mesh repair group with a ‗p' value of 0.006 which is statistically significant.…”

Section: Discussionmentioning

confidence: 99%

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A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

Chitrambalam¹,

Anguraj²,

Sundaraj³

et al. 2019

Int Surg J

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Background: Ventral hernias are one of the most common surgical problems of the modern age. About 15-18% of all the surgical procedures performed around the world comprises of hernia repair. This study aims to compare the two common options of mesh placement in open ventral hernia repairs; over the anterior rectus sheath, the ‘Onlay meshplasty’ and in the retrorectus plane, the ‘Sublay meshplasty’.Methods: A prospective controlled study was done between March 2017 to August 2018 on 150 patients with ventral hernia randomizing patients into 2 groups. Group A (Onlay meshplasty) and Group B (Sublay meshplasty). Duration of surgery, post-operative pain, wound infection, duration of hospital stay and recurrences were analysed with 12 months follow up.Results: The mean duration of surgery in group A was 48.49±0.71 minutes and in group B was 72.84±0.72 minutes. Group B experienced significantly lesser pain when compared with group A. The mean asepsis score in group A was 3.60±1.09 and in group B was 0.47±0.30 with a p value of 0.006. Group A had significantly longer hospital stay (9.39 days) than group B (5.71 days). The recurrences in both the groups were statistically insignificant (Group A- 2 patients; Group B- 1 patient).Conclusions: Sublay meshplasty although requires longer time to perform, proves to be a better alternate in terms of post-operative pain, wound infection and hospital stay.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

Chitrambalam¹,

Anguraj²,

Sundaraj³

et al. 2019

Int Surg J

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“…Respected Editor, Over the past decade, repair of ventral hernias with a mesh as opposed to primary closure with a suture has substantially improved the outcomes and has been accepted as the standard of care [1]. For laparoscopic repair, the mesh is placed in the preperitoneal space, but for open repair, multiple options are available.…”

mentioning

confidence: 99%

“…Recent and past literature have compared onlay and sublay repair, and sublay repair is widely accepted as the standard of care for the open approach. Each mesh repair has its theoretical benefits and risks [1]. Onlay repair is technically not as challenging as the sublay; however, it protects the mesh from intraperitoneal contents but at the same time is exposed to superficial wound infections.…”

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confidence: 99%

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Reviving Onlay Ventral Hernia Repair: a Novel Concept of Using a Hernia Stapler for Securing the Mesh

2018

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Short-term complications after onlay versus preperitoneal mesh repair of umbilical hernias: a prospective randomized double-blind trial

Fonseca

Tarso²,

Gus³

et al. 2023

Langenbecks Arch Surg

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PURPOSE: To compare the incidence of surgical site occurrences (SSOs) following onlay versus preperitoneal mesh placement in elective open umbilical hernia repairs.METHODS: This study presents a secondary analysis of a randomized double-blind trial conducted on female patients with primary umbilical hernias admitted to a general hospital, in a residency training program setting. Fifty-six subjects were randomly assigned to either onlay (n=30) or preperitoneal (n=26) mesh repair group. Data on baseline demographics, past medical history, perioperative details, postoperative pain (visual analogue scale, VAS), wound-related complications and recurrence were assessed using a standardized protocol.RESULTS: No statistically signi cant differences were observed between groups regarding patients' demographics, comorbidities or defect size. Operative time averaged 67.5 (28 -110) minutes for onlay and 50.5 (31 -90) minutes for preperitoneal repairs, p=.03. The overall rate of SSOs was 21.4% (n=12), mainly in the onlay group (33% vs 7.7%; p=0.02, 95% CI 0.03 -0.85) and mostly due to seromas. There were no between-group signi cant differences in postoperative VAS scores at all timepoints. After a maximum follow-up of 48 months, one recurrence was reported in the onlay group. By logistic regression, the onlay technique was the only independent risk factor for SSOs.CONCLUSION: The presented data identi ed a decreased wound morbidity in preperitoneal umbilical hernia repairs, thus providing a good level of evidence for recommendations regarding mesh place selection in future guidelines. Further cases from this ongoing study and completion of follow-up are expected to also compare both techniques in terms of long-term outcomes.

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Open Treatment of Abdominal Wall Hernias: Mesh Repair is Superior to Suture Repair and Onlay Mesh is Better than Sublay Mesh Five-Year Multicentric, Prospective, Randomised Clinical Trial

Cited by 12 publications

References 32 publications

A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

A comparative study between onlay and sublay meshplasty in ventral hernias: a randomized controlled trial

Reviving Onlay Ventral Hernia Repair: a Novel Concept of Using a Hernia Stapler for Securing the Mesh

Short-term complications after onlay versus preperitoneal mesh repair of umbilical hernias: a prospective randomized double-blind trial

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