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STRONGHOLD first-year results of biomechanically calculated abdominal wall repair: a propensity score matching

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Název: STRONGHOLD first-year results of biomechanically calculated abdominal wall repair: a propensity score matching
Autoři: Lesch, Carolin, Nessel, R., Adolf, D., Hukauf, M., Köckerling, F., Kallinowski, F., For the STRONGHOLD/Herniamed-Collaborators GROUP, Willms, A., Schwab, R., Zarras, K.
Zdroj: Hernia
Informace o vydavateli: Springer Science and Business Media LLC, 2023.
Rok vydání: 2023
Témata: Abdominal Wall, Humans, Incisional Hernia, Pain, Original Article, Propensity Score, Herniorrhaphy, Hernia, Ventral, Abdominal Wall/surgery [MeSH], Pain/surgery [MeSH], Humans [MeSH], STRONGHOLD, Hernia, Ventral/surgery [MeSH], Herniorrhaphy/adverse effects [MeSH], Propensity score matching for incisional hernia repair, Herniamed, Incisional hernia, Biomechanically calculated incisional hernia repair, Propensity Score [MeSH], Incisional Hernia/surgery [MeSH], Herniorrhaphy/methods [MeSH], Abdominal wall reconstruction, 3. Good health
Popis: Purpose Every year around 70,000 people in Germany suffer from an abdominal incisional hernia that requires surgical treatment. Five years after reconstruction about 25% reoccur. Incisional hernias are usually closed with mesh using various reconstruction techniques, summarized here as standard reconstruction (SR). To improve hernia repair, we established a concept for biomechanically calculated reconstructions (BCR). In the BCR, two formulas enable customized patient care through standardized biomechanical measures. This study aims to compare the clinical outcomes of SR and BCR of incisional hernias after 1 year of follow-up based on the Herniamed registry. Methods SR includes open retromuscular mesh augmented incisional hernia repair according to clinical guidelines. BCR determines the required strength (Critical Resistance to Impacts related to Pressure = CRIP) preoperatively depending on the hernia size. It supports the surgeon in reliably determining the Gained Resistance, based on the mesh-defect-area-ratio, further mesh and suture factors, and the tissue stability. To compare SR and BCR repair outcomes in incisional hernias at 1 year, propensity score matching was performed on 15 variables. Included were 301 patients with BCR surgery and 23,220 with standard repair. Results BCR surgeries show a significant reduction in recurrences (1.7% vs. 5.2%, p = 0.0041), pain requiring treatment (4.1% vs. 12.0%, p = 0.001), and pain at rest (6.9% vs. 12.7%, p = 0.033) when comparing matched pairs. Complication rates, complication-related reoperations, and stress-related pain showed no systematic difference. Conclusion Biomechanically calculated repairs improve patient care. BCR shows a significant reduction in recurrence rates, pain at rest, and pain requiring treatment at 1-year follow-up compared to SR.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1248-9204
DOI: 10.1007/s10029-023-02897-7
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/37815731
https://repository.publisso.de/resource/frl:6524008
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....b28a4572433e2b8273f3aa2b93a4257c
Databáze: OpenAIRE
Popis
Abstrakt:Purpose Every year around 70,000 people in Germany suffer from an abdominal incisional hernia that requires surgical treatment. Five years after reconstruction about 25% reoccur. Incisional hernias are usually closed with mesh using various reconstruction techniques, summarized here as standard reconstruction (SR). To improve hernia repair, we established a concept for biomechanically calculated reconstructions (BCR). In the BCR, two formulas enable customized patient care through standardized biomechanical measures. This study aims to compare the clinical outcomes of SR and BCR of incisional hernias after 1 year of follow-up based on the Herniamed registry. Methods SR includes open retromuscular mesh augmented incisional hernia repair according to clinical guidelines. BCR determines the required strength (Critical Resistance to Impacts related to Pressure = CRIP) preoperatively depending on the hernia size. It supports the surgeon in reliably determining the Gained Resistance, based on the mesh-defect-area-ratio, further mesh and suture factors, and the tissue stability. To compare SR and BCR repair outcomes in incisional hernias at 1 year, propensity score matching was performed on 15 variables. Included were 301 patients with BCR surgery and 23,220 with standard repair. Results BCR surgeries show a significant reduction in recurrences (1.7% vs. 5.2%, p = 0.0041), pain requiring treatment (4.1% vs. 12.0%, p = 0.001), and pain at rest (6.9% vs. 12.7%, p = 0.033) when comparing matched pairs. Complication rates, complication-related reoperations, and stress-related pain showed no systematic difference. Conclusion Biomechanically calculated repairs improve patient care. BCR shows a significant reduction in recurrence rates, pain at rest, and pain requiring treatment at 1-year follow-up compared to SR.
ISSN:12489204
DOI:10.1007/s10029-023-02897-7