Mesh versus direct suture for the repair of umbilical and epigastric hernias. Ten-year experience.
BACKGROUND
The objective of this study was to evaluate outcomes of mesh versus primary suture procedures for repair of anterior abdominal wall midline hernias.


RESULTS
Between 1995 and 2005, 98 patients (46 males) underwent repair of umbilical (69 cases) or epigastric (29 cases) hernias. Primary suture of the defect was performed in 34 cases (group 1). A polypropylene mesh was positioned in 64 cases (group 2). Overall, mean aponeurotic defect diameter was 2.5 cm (range 0.5 +/- 10 cm). Procedures were carried out under local anesthesia in 76 instances (71% group 1 vs. 81% group 2). Complications occurring in group 2 comprised three seromas, one hematoma and one prosthetic infection. Follow up was scheduled yearly up to the fifth postoperative year. Recurrence rate in group 1 was 14.7% compared to 3.1% in group 2 (logrank test p 0.0475).


CONCLUSIONS
Anterior preperitoneal mesh repair of abdominal wall midline hernias under local anesthesia seems to be a safe and effective technique that can be performed as a day surgery procedure. A slightly increased risk of postoperative local complications following mesh repair is offset by a reduced rate of recurrence in comparison to suture repair.
Department of Surgery, School of Medicine, University of Genoa, Italy.
Cesare
C
Stabilini
Mattis
M
Stella
Marco
M
Frascio
Luigi
L
De Salvo
Rosario
R
Fornaro
Giancarlo
G
Larghero
Francesca
F
Mandolfino
Fabrizio
F
Lazzara
Ezio
E
Gianetta
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D013997:Time Factors