Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair
Objective:. To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh. Summary Background Data:. Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%....
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2023-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000366 |
| _version_ | 1797375055485730816 |
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| author | L. M. Van den Dop, MD M. M. J. Van Rooijen, MD, PhD T. Tollens, MD L. N. Jørgensen, MD, PhD T. S. De Vries-Reilingh, MD, PhD G. Piessen, MD, PhD F. Köckerling, MD, PhD M. Miserez, MD, PhD M. Dean, MD F. Berrevoet, MD, PhD B. Dousset, MD, PhD H. L. Van Westreenen, MD, PhD F. Gossetti, MD, PhD G. W. M. Tetteroo, MD, PhD A. Koch, MD, PhD M. F. Boomsma, MD, PhD J. F. Lange, MD, PhD J. Jeekel, MD, PhD |
| author_facet | L. M. Van den Dop, MD M. M. J. Van Rooijen, MD, PhD T. Tollens, MD L. N. Jørgensen, MD, PhD T. S. De Vries-Reilingh, MD, PhD G. Piessen, MD, PhD F. Köckerling, MD, PhD M. Miserez, MD, PhD M. Dean, MD F. Berrevoet, MD, PhD B. Dousset, MD, PhD H. L. Van Westreenen, MD, PhD F. Gossetti, MD, PhD G. W. M. Tetteroo, MD, PhD A. Koch, MD, PhD M. F. Boomsma, MD, PhD J. F. Lange, MD, PhD J. Jeekel, MD, PhD |
| author_sort | L. M. Van den Dop, MD |
| collection | DOAJ |
| description | Objective:. To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh.
Summary Background Data:. Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12–18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce.
Methods:. Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0–10].
Results:. In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55–64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9–24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0–2).
Conclusions:. Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection. |
| first_indexed | 2024-03-08T19:16:42Z |
| format | Article |
| id | doaj.art-9721d6902cc242f380561118d5651c8e |
| institution | Directory Open Access Journal |
| issn | 2691-3593 |
| language | English |
| last_indexed | 2024-03-08T19:16:42Z |
| publishDate | 2023-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj.art-9721d6902cc242f380561118d5651c8e2023-12-27T06:49:28ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932023-12-0144e36610.1097/AS9.0000000000000366202312000-00026Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia RepairL. M. Van den Dop, MD0M. M. J. Van Rooijen, MD, PhD1T. Tollens, MD2L. N. Jørgensen, MD, PhD3T. S. De Vries-Reilingh, MD, PhD4G. Piessen, MD, PhD5F. Köckerling, MD, PhD6M. Miserez, MD, PhD7M. Dean, MD8F. Berrevoet, MD, PhD9B. Dousset, MD, PhD10H. L. Van Westreenen, MD, PhD11F. Gossetti, MD, PhD12G. W. M. Tetteroo, MD, PhD13A. Koch, MD, PhD14M. F. Boomsma, MD, PhD15J. F. Lange, MD, PhD16J. Jeekel, MD, PhD17From the * Department of Surgery, Erasmus University Medical Centre, Rotterdam, the NetherlandsFrom the * Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands† Department of Surgery, Imelda Hospital, Bonheiden, Belgium‡ Department of Surgery, Bispebjerg Hospital, Copenhagen, Denmark§ Department of Surgery, Elkerliek Hospital, Helmond, the Netherlands‖ Department of Surgery, University Hospital Lille, Lille, France¶ Department of Surgery, Vivantes Klinikum Spandau, Berlin, Germany# Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium** Department of Surgery, University College London Hospital, London, United Kingdom†† Department of Surgery, University Hospital Gent, Gent, Belgium‡‡ Department of Surgery, Hôpital Cochin, Paris, France§§ Department of Surgery, Isala Hospital, Zwolle, the Netherlands‖‖ Department of Surgery, Università di Roma Sapienza, Rome, Italy¶¶ Department of Surgery, IJsselland Hospital, Capelle aan den IJssel, the Netherlands## Department of Surgery, Chirurgische Praxis Ärztehaus, Cottbus, Germany*** Department of Radiology, Isala hospital, Zwolle, the Netherlands.From the * Department of Surgery, Erasmus University Medical Centre, Rotterdam, the NetherlandsFrom the * Department of Surgery, Erasmus University Medical Centre, Rotterdam, the NetherlandsObjective:. To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh. Summary Background Data:. Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12–18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce. Methods:. Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0–10]. Results:. In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55–64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9–24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0–2). Conclusions:. Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.http://journals.lww.com/10.1097/AS9.0000000000000366 |
| spellingShingle | L. M. Van den Dop, MD M. M. J. Van Rooijen, MD, PhD T. Tollens, MD L. N. Jørgensen, MD, PhD T. S. De Vries-Reilingh, MD, PhD G. Piessen, MD, PhD F. Köckerling, MD, PhD M. Miserez, MD, PhD M. Dean, MD F. Berrevoet, MD, PhD B. Dousset, MD, PhD H. L. Van Westreenen, MD, PhD F. Gossetti, MD, PhD G. W. M. Tetteroo, MD, PhD A. Koch, MD, PhD M. F. Boomsma, MD, PhD J. F. Lange, MD, PhD J. Jeekel, MD, PhD Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair Annals of Surgery Open |
| title | Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair |
| title_full | Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair |
| title_fullStr | Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair |
| title_full_unstemmed | Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair |
| title_short | Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair |
| title_sort | five year follow up of a slowly resorbable biosynthetic p4hb mesh phasix in vhwg grade 3 incisional hernia repair |
| url | http://journals.lww.com/10.1097/AS9.0000000000000366 |
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