SLIM-MESH: 12-YEAR FOLLOW-UP STUDY ON MID-TERM RESULTS IN 120 PATIENTS
INCLUDING 58 OBESE
EAES Academy. Canton S. 07/05/22; 363087; P132
INCLUDING 58 OBESE
Dr. Silvio Alen Canton
Contributions
Contributions
Abstract
Aims Using the sutureless “Slim-Mesh” technique (SM) to render the best therapeutic treatment plan for patients with ventral hernia (VH), including large (L)-giant (G)/massive (M) types and obese/super obese patients (O/SO), likely resulting in decreased operation time (OT) and intra- (IO)/post-operative (PO) complications, as well as decreased postoperative chronic abdominal-wall pain (CAP) and recurrence (R).
Methods From September 2009 to October 2021, 120 VH patients, including many O (BMI 30-49.9 kg/m2)/SO (BMI 50-59.9 kg/m2) patients, 43 of which with L (10-14.9 cm in diameter for circular or major axis for oval ones)-G (15-19.9 cm) and M (≥20 cm) VH, were treated with the SM technique at our Department. This was a prospective (72%)-retrospective 12-year follow-up study to analyze the mid-term results (m.t.).
Results Our study comprised 59 males and 61 females, with overall mean age and BMI being 59 years old and 29 kg/m² respectively. Fifty-seven (48%) patients were O and one was SO. Laparoscopy (LAP) found 77 small (S 2-4.9 cm)-medium (Me 5-9.9 cm) VH, 37 L-G, and 6 M. Mean OT was 98 minutes for all 120 patients, 88 min. for S-Me VH patients, 104 min. for L-G, and 190 min. for M. In 27% of cases, VH LAP size was larger than pre-operative size, and in 14%, LAP detected additional-VH undetected by US and/or CT-scan. A composite mesh and a non-composite mesh were employed in 93% and 7% of cases respectively. Absorbable straps and titanium-tacks were used in 88% and 12% of cases respectively. Mean hospital-stay was 2.3 days and mean follow-up time was 4 years. There was one case of CAP, and 12 late PO complications: 7 VH recurrences (6%) and 5 trocar-site hernias. Conclusions There is no consensus of literature on the optimal therapeutic treatment for patients with L-G/M VH and O/SO VH patients; however, our study confirms that the SM technique significantly helps to reduce OT and IO/PO complications, even when treating these two categories. In our experience, the SM technique is justified for VH patients, especially those with L-G/M VH, as well as for O/SO VH patients, thus strengthening the role of LAP.
Methods From September 2009 to October 2021, 120 VH patients, including many O (BMI 30-49.9 kg/m2)/SO (BMI 50-59.9 kg/m2) patients, 43 of which with L (10-14.9 cm in diameter for circular or major axis for oval ones)-G (15-19.9 cm) and M (≥20 cm) VH, were treated with the SM technique at our Department. This was a prospective (72%)-retrospective 12-year follow-up study to analyze the mid-term results (m.t.).
Results Our study comprised 59 males and 61 females, with overall mean age and BMI being 59 years old and 29 kg/m² respectively. Fifty-seven (48%) patients were O and one was SO. Laparoscopy (LAP) found 77 small (S 2-4.9 cm)-medium (Me 5-9.9 cm) VH, 37 L-G, and 6 M. Mean OT was 98 minutes for all 120 patients, 88 min. for S-Me VH patients, 104 min. for L-G, and 190 min. for M. In 27% of cases, VH LAP size was larger than pre-operative size, and in 14%, LAP detected additional-VH undetected by US and/or CT-scan. A composite mesh and a non-composite mesh were employed in 93% and 7% of cases respectively. Absorbable straps and titanium-tacks were used in 88% and 12% of cases respectively. Mean hospital-stay was 2.3 days and mean follow-up time was 4 years. There was one case of CAP, and 12 late PO complications: 7 VH recurrences (6%) and 5 trocar-site hernias. Conclusions There is no consensus of literature on the optimal therapeutic treatment for patients with L-G/M VH and O/SO VH patients; however, our study confirms that the SM technique significantly helps to reduce OT and IO/PO complications, even when treating these two categories. In our experience, the SM technique is justified for VH patients, especially those with L-G/M VH, as well as for O/SO VH patients, thus strengthening the role of LAP.
Aims Using the sutureless “Slim-Mesh” technique (SM) to render the best therapeutic treatment plan for patients with ventral hernia (VH), including large (L)-giant (G)/massive (M) types and obese/super obese patients (O/SO), likely resulting in decreased operation time (OT) and intra- (IO)/post-operative (PO) complications, as well as decreased postoperative chronic abdominal-wall pain (CAP) and recurrence (R).
Methods From September 2009 to October 2021, 120 VH patients, including many O (BMI 30-49.9 kg/m2)/SO (BMI 50-59.9 kg/m2) patients, 43 of which with L (10-14.9 cm in diameter for circular or major axis for oval ones)-G (15-19.9 cm) and M (≥20 cm) VH, were treated with the SM technique at our Department. This was a prospective (72%)-retrospective 12-year follow-up study to analyze the mid-term results (m.t.).
Results Our study comprised 59 males and 61 females, with overall mean age and BMI being 59 years old and 29 kg/m² respectively. Fifty-seven (48%) patients were O and one was SO. Laparoscopy (LAP) found 77 small (S 2-4.9 cm)-medium (Me 5-9.9 cm) VH, 37 L-G, and 6 M. Mean OT was 98 minutes for all 120 patients, 88 min. for S-Me VH patients, 104 min. for L-G, and 190 min. for M. In 27% of cases, VH LAP size was larger than pre-operative size, and in 14%, LAP detected additional-VH undetected by US and/or CT-scan. A composite mesh and a non-composite mesh were employed in 93% and 7% of cases respectively. Absorbable straps and titanium-tacks were used in 88% and 12% of cases respectively. Mean hospital-stay was 2.3 days and mean follow-up time was 4 years. There was one case of CAP, and 12 late PO complications: 7 VH recurrences (6%) and 5 trocar-site hernias. Conclusions There is no consensus of literature on the optimal therapeutic treatment for patients with L-G/M VH and O/SO VH patients; however, our study confirms that the SM technique significantly helps to reduce OT and IO/PO complications, even when treating these two categories. In our experience, the SM technique is justified for VH patients, especially those with L-G/M VH, as well as for O/SO VH patients, thus strengthening the role of LAP.
Methods From September 2009 to October 2021, 120 VH patients, including many O (BMI 30-49.9 kg/m2)/SO (BMI 50-59.9 kg/m2) patients, 43 of which with L (10-14.9 cm in diameter for circular or major axis for oval ones)-G (15-19.9 cm) and M (≥20 cm) VH, were treated with the SM technique at our Department. This was a prospective (72%)-retrospective 12-year follow-up study to analyze the mid-term results (m.t.).
Results Our study comprised 59 males and 61 females, with overall mean age and BMI being 59 years old and 29 kg/m² respectively. Fifty-seven (48%) patients were O and one was SO. Laparoscopy (LAP) found 77 small (S 2-4.9 cm)-medium (Me 5-9.9 cm) VH, 37 L-G, and 6 M. Mean OT was 98 minutes for all 120 patients, 88 min. for S-Me VH patients, 104 min. for L-G, and 190 min. for M. In 27% of cases, VH LAP size was larger than pre-operative size, and in 14%, LAP detected additional-VH undetected by US and/or CT-scan. A composite mesh and a non-composite mesh were employed in 93% and 7% of cases respectively. Absorbable straps and titanium-tacks were used in 88% and 12% of cases respectively. Mean hospital-stay was 2.3 days and mean follow-up time was 4 years. There was one case of CAP, and 12 late PO complications: 7 VH recurrences (6%) and 5 trocar-site hernias. Conclusions There is no consensus of literature on the optimal therapeutic treatment for patients with L-G/M VH and O/SO VH patients; however, our study confirms that the SM technique significantly helps to reduce OT and IO/PO complications, even when treating these two categories. In our experience, the SM technique is justified for VH patients, especially those with L-G/M VH, as well as for O/SO VH patients, thus strengthening the role of LAP.
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