Efficacy analysis of porcine small intestine submucosa-derived mesh and polypropylene mesh applied in anterior abdominal wall incisional hernia repair / 中华消化外科杂志

Objective To investigate the clinical efficacy of porcine small intestine submucosa-derived (SIS) mesh and polypropylene (PP) mesh applied in anterior abdominal wall incisional hernia repair.Methods The retrospective cohort study was conducted.The clinical data of 59 patients who underwent anterior abdominal wall incisional hernia repair in the First Affiliated Hospital of Sun Yat-Sen University between January 2012 and December 2017 were collected.Of 59 patients,22 undergoing anterior abdominal wall incisional hernia repair with SIS mesh and 37 undergoing anterior abdominal wall incisional hernia repair with PP mesh were respectively allocated into the SIS group and PP group.Surgeons selected surgical procedures according to hernia ring situations of patients.Observation indicators:(l) intra-and post-operative recovery situations;(2) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect long-term complications of patients including foreign body sensation or pain in abdominal wall and hernia recurrence up to May 2018.Measurement data with normal distribution were represented as (x)±s,and comparison between groups was done using t test.Measurement data with skewed distribution were described as M (range),and comparison between groups was done using Mann-Whitney U test.Comparison of count data was analyzed using the chi-square test or Fisher exact probability.Results (1) Intra-and post-operative recovery situations:patients of the SIS group and PP group underwent successfully anterior abdominal wall incisional hernia repair.There were 2,3,3,14 and 5,26,1,5 patients undergoing open Onlay repair,open Sublay repair,laparoscopic intraperitoneal onlay mesh repair,laparoscopic combined with open mesh repair in the SIS group and PP group respectively.The volume of intraoperative blood loss,cases of postoperative incisional seroma and surgical site infection were (23± 11)mL,7,5 in the SIS group and (30± 13)mL,3,1 in the PP group respectively,with statistically significant differences between groups (t=-2.238,P＜0.05).(2) Follow-up:patients of the SIS group and PP group were respectively followed up for 29.3 months (6.0-66.0 months) and 31.0 months (7.0-76.0 months),with no statistically significant difference between groups (Z =-1.388,P＞0.05).During the follow-up,foreign body sensation or pain in abdominal wall and hernia recurrence were detected in 6,6 patients in the SIS group and 4,2 patients in the PP group respectively,with a statistically significant difference in hernia recurrence between groups (P＜0.05) and with no statistically significant difference in foreign body sensation or pain in abdominal wall between groups (P＞0.05).Conclusion Compared with polypropylene mesh,anterior abdominal wall incisional hernia repair using SIS mesh has higher incidence rate of postoperative incisional seroma,surgical site infection and hernia recurrence,but fewer volume of intraoperative blood loss.

Clinical value of component separation technology reducing postoperative recurrence after giant abdominal wall incisional herniorrhaphy / 中华消化外科杂志

How to repair and reconstruct giant abdominal wall incisional hernia effectively,is still a difficult problem for surgeons of hernia and abdominal wall surgery.Component separation technology based on mesh reinforcement provides an excellent method to repair and reconstruct giant abdominal wall incisional hernia in anatomy and function,and possesses an lower recurrence rate than primary suture and bridged mesh repair.Standardized component separation technology plays an important role in improving the therapeutic effect of giant abdominal wall incisional hernia.