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ACS: Re-Op Risk Down for Open, Laparoscopic Mesh Hernia Repair

But progressively increasing number of mesh-related complications during follow-up

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WEDNESDAY, Oct. 19, 2016 (HealthDay News) -- Patients undergoing open and laparoscopic mesh hernia repair have lower risk of reoperation for recurrence than those undergoing open repair without use of mesh, according to a study published in the Oct. 18 issue of the Journal of the American Medical Association. The research was published to coincide with the annual meeting of the American College of Surgeons, held from Oct. 16 to 20 in Washington, D.C.

Dunja Kokotovic, from Zealand University Hospital in Køge, Denmark, and colleagues conducted a registry-based study including 3,242 patients with elective incisional hernia repair. Patients were assessed for five-year risk of reoperation for recurrence and five-year risk of all mesh-related complications necessitating subsequent surgery.

The researchers found that patients with open mesh repair and laparoscopic mesh repair had lower risk of the need for repair for recurrent hernia than those who had nonmesh repair (12.3 and 10.6 percent, respectively, versus 17.1 percent). For open and laparoscopic procedures, there was a progressively increasing number of mesh-related complications during follow-up. The cumulative incidence of mesh-related complications was 5.6 and 3.7 percent for patients who underwent open mesh hernia repair and laparoscopic mesh repair, respectively, at five years of follow-up. For patients with an initial nonmesh repair, the long-term repair-related complication rate was 0.8 percent.

"Among patients undergoing incisional repair, sutured repair was associated with a higher risk of reoperation for recurrence over five years compared with open mesh and laparoscopic mesh repair," the authors write. "With long-term follow-up, the benefits attributable to mesh are offset in part by mesh-related complications."

One author disclosed financial ties to the pharmaceutical industry.

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