The Effects of Operation Technique on Recurrence of Incisional Hernia Repair

Özet

Objectives: The selection of incision type, closure type of incision and the suture material are some of the important factors to prevent hernia development. We should aim to perform the best procedure with the best technique to reduce the risk of recurrence.Surgical options include primary repair and open or laparoscopic repair with mesh. Mesh repairs can be performed as onlay, sublayor inlay according to the area where the mesh is to be laid. In this retrospective study, our main goal was to compare the recurrencerates in patients who underwent incisional hernia repair with onlay and inlay mesh techniques.Methods: This retrospective study included 185 patients who underwent surgery due to incisional hernia in our clinic betweenJanuary 2012 and October 2017. Patients were divided into two groups according to the technique as Group 1 with onlay meshrepair and Group 2 with inlay mesh repair. The same type of mesh (prolen) was applied to all patients.Results: There were 121 patients in Group 1 and 64 patients in Group 2. According to data we obtained, 64.3% of the patients werewomen and the mean age of all patients was 58.4±16.4 years. Postoperative complications (such as seroma-hematoma, surgicalsite infection, mesh rejection, postoperative ileus) developed in 29.2% (n=54) of the patients. The length of hospital stay was 4.2±3days in Group 1 and 5.6±5 days in Group 2. The mean follow-up period was 48.6 months (24-93 months), with the recurrence ratesof 5.8% (n=7) in Group 1 and 10.9% (n=7) in Group 2, respectively. There was a statistically significant difference between thegroups concerning comorbidity, postoperative complications, the length of hospitalization stay and recurrence.Conclusion: We believe that the onlay technique will be more appropriate than the inlay technique when only prolen mesh ispreferred because the recurrence rates are higher in the inlay technique.