Using Mesh for Hernia Repair Shows Mixed Results

By HospiMedica International staff writers
Posted on 04 Nov 2016

Although mesh reinforcement for hernia repair is associated with several benefits, these are offset by mesh-related complications, claims a new study.

Researchers at Hvidovre Hospital (Denmark) and Zealand University Hospital (Køge, Denmark) conducted a study that included 3,242 patients (average age 59; 53% women), who underwent elective incisional hernia repairs in Denmark from January 2007 to December 2010. Among these, 35% underwent open mesh repair, 11% had open non-mesh repair, and 54% had laparoscopic mesh repair. Median follow-up for all procedures was about five years.

Image: The hernia sac and contents are returned to place and the hernia repaired with mesh (Photo courtesy Dr. G. Tan).

The results showed that the risk of subsequent recurrent hernia was lower for patients with open mesh repair (12%) and for patients with laparoscopic mesh repair (10.6%), than for those who had non-mesh repair (17.1%). A progressively increasing number of mesh-related complications, including bleeding, bowel obstruction, bowel perforation, and late abscess, were also noted. At five years of follow-up, the cumulative incidence of mesh-related complications was 5.6% for patients who underwent open mesh hernia repair and 3.7% for patients who underwent laparoscopic mesh repair.

Conversely, the long-term repair-related complication rate for patients with an initial non-mesh repair was 0.8%. The researchers commented, however, that larger, more complicated hernias are likely to be repaired with mesh, while small, simple hernias with little likelihood of long-term problems tend to be repaired without mesh. The study was presented at the American College of Surgeons (ACS) clinical congress, held during October 2016 in Washington (DC, USA).

“Mesh implantation prevented the need for subsequent reoperation in relatively few patients, suggesting that the benefits associated with the use of mesh are partially off¬set by long-term complications associated with its use,” concluded senior author Thue Bisgaard, MD, PhD, of Hvidovre Hospital, and colleagues. “The complete spectrum for the risks and benefits of mesh used to reinforce hernia repair is not known, because there are very few clinical trial data reporting hernia outcomes as they pertain to mesh utilization.”

Related Links:
Hvidovre Hospital
Zealand University Hospital