Prophylactic Intraperitoneal Onlay Mesh Following Midline Laparotomy—Long-Term Results of a Randomized Controlled Trial

Objectives Incisional hernia, a serious complication after laparotomy, is associated with high morbidity and costs. This trial examines the value of prophylactic intraperitoneal onlay mesh to reduce the risk of incisional hernia after a median follow-up time of 5.3 years. Methods We conducted a para...

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Bibliographic Details
Published in:World journal of surgery 2019-07, Vol.43 (7), p.1669-1675
Main Authors: Glauser, Philippe M., Brosi, Philippe, Speich, Benjamin, Käser, Samuel A., Heigl, Andres, Rosenberg, Robert, Maurer, Christoph A.
Format: Article
Language:English
Subjects:
Abdomen - surgery
Abdominal Surgery
Abdominal wall
Abdominal Wound Closure Techniques
Cardiac Surgery
Clinical trials
Follow-Up Studies
General Surgery
Hernia
Hernia, Ventral - etiology
Hernia, Ventral - prevention & control
Hernia, Ventral - surgery
Hernias
Herniorrhaphy
Humans
Incisional Hernia - etiology
Incisional Hernia - prevention & control
Incisional Hernia - surgery
Medicine
Medicine & Public Health
Morbidity
Original Scientific Report
Patients
Postoperative Complications - etiology
Postoperative Complications - prevention & control
Postoperative Complications - surgery
Randomization
Risk
Signs and symptoms
Surgery
Surgical Mesh - adverse effects
Sutures
Thoracic Surgery
Vascular Surgery
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Summary:Objectives Incisional hernia, a serious complication after laparotomy, is associated with high morbidity and costs. This trial examines the value of prophylactic intraperitoneal onlay mesh to reduce the risk of incisional hernia after a median follow-up time of 5.3 years. Methods We conducted a parallel group, open-label, single center, randomized controlled trial (NCT01003067). After midline incision, the participants were either allocated to abdominal wall closure according to Everett with a PDS-loop running suture reinforced by an intraperitoneal composite mesh strip (Group A ) or the same procedure without the additional mesh strip (Group B ). Results A total of 276 patients were randomized (Group A  = 131; Group B  = 136). Follow-up data after a median of 5.3 years after surgery were available from 183 patients (Group A  = 95; Group B  = 88). Incisional hernia was diagnosed in 25/95 (26%) patients in Group A and in 46/88 (52%) patients in Group B (risk ratio 0.52; 95% CI 0.36–0.77; p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-019-04964-6