Prophylactic Mesh-related Reoperations and Mesh-related Problems During Subsequent Relaparotomies
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Le résumé fourni par la source
OBJECTIVE: To evaluate all mesh-related problems during reoperations after mesh reinforcement of the abdominal wall 15 years after the start of the PRIMA trial. BACKGROUND: Prophylactic mesh reinforcement during closure of a midline laparotomy has proven to reduce the incidence of incisional hernia, especially in high-risk patients, but long-term mesh-related morbidity is largely unknown. METHODS: Patients receiving a prophylactic onlay or retrorectus mesh in the PRIMA trial between 2009 and 2012 were included on an as-treated basis from participating centers that made reoperation notes available. The main outcomes were the incidences of complications requiring mesh explantation, mesh-related ileus, and mesh-related problems during laparotomy for other diagnoses. RESULTS: Out of 373 patients randomized to prophylactic mesh reinforcement, 242 were included: 127 with onlay and 115 patients with retrorectus mesh. Median follow-up is 27 months (interquartile range: 12-78). Thirty-four patients underwent reoperation for any reason during the entire follow-up, 22 after onlay (17.3%), and 12 after retrorectus mesh (10.4%). The reoperation rate for complications that required mesh explantation was 4/127 (3.1%) after onlay and 0/115 (0%) after retrorectus mesh. Mesh-related ileus occurred in none of the onlay group, and 3/115 (2.6%) in the retrorectus group. During subsequent laparotomies for other primary diagnoses, adhesions to the mesh were noted in 3/10 patients in the onlay group and 1/5 patients in the retrorectus group. Overall, the mesh was removed in 10/127 (7.9%) in the onlay group and 7/115 (6.1%) patients in the retrorectus group. CONCLUSIONS: In high-risk patients receiving a prophylactic mesh during midline laparotomy closure, low incidences of mesh-related complications requiring reoperation and mesh-related problems during unrelated subsequent laparotomies were found, for both the onlay and retrorectus techniques.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Prophylactic Mesh-related Reoperations and Mesh-related Problems During Subsequent Relaparotomies
- Date Crossref
- 06/09/2024
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
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Erasmus University Rotterdam pays non établi dans la noticeUniversité ou école supérieure
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Radboud University Nijmegen pays non établi dans la noticeUniversité ou école supérieure
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Treant Zorggroep pays non établi dans la noticeÉtablissement de santé
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Isala Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Maastricht University pays non établi dans la noticeUniversité ou école supérieure
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Máxima Medisch Centrum pays non établi dans la noticeÉtablissement de santé
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Erasmus University Medical Centre Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
Erasmus University Rotterdam, Radboud University Nijmegen et Treant Zorggroep, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.