Association of mesh weight with adverse outcomes: a cohort study including 123,880 inguinal hernia repairs
- 01.12.2025
- Original Article
Erschienen in:
- Verfasst von
- Brandon Cowan
- Priscilla H. Chan
- Sahil S. Patel
- Heather A. Prentice
- Kenneth Sucher
- Elizabeth W. Paxton
- Elliott R. Brill
- Lavina Malhotra
- Francisca M. Maertens
- Gregory M. Heitmann
- Rouzbeh Mostaedi
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
Surgeons lack conclusive evidence to guide mesh choice for inguinal hernia repair. We sought to evaluate risk for recurrence, reoperation, and chronic postoperative inguinal pain (CPIP) compared among different mesh weight classes.
Methods
We conducted a cohort study including 123,880 repairs in adult patients who underwent first elective mesh-based inguinal hernia repair within a US integrated healthcare system (1/2010-6/2023). Mesh weight was categorized into lightweight (LW, < 50 g), medium-weight (MW, 50–90 g), and heavyweight (HW, > 90 g). Recurrence and reoperation during follow-up were primary outcomes while 5-year CPIP was a secondary outcome. Multivariable Cox regression was used to evaluate risk of primary outcomes, while multivariable logistic regression was used to evaluate the secondary outcome; all models included covariate adjustment and stratified by surgery type.
Results
LW, MW, and HW mesh were used in 49.0% (n = 23,685), 3.8% (n = 1,811), and 47.2% (n = 22,815) of minimally invasive (MIS) procedures, respectively; and were used in 55.7% (n = 42,097), 25.4% (n = 19,183), and 18.9% (n = 14,289) of open procedures, respectively. Among MIS repairs, LW mesh was associated with a lower risk of recurrence, reoperation, and CPIP versus HW, and a lower risk of recurrence and reoperation versus MW. Among open repairs, no difference was seen between LW and MW for recurrence, reoperation, and CPIP, while HW had a lower risk for recurrence and reoperation, but a higher likelihood of CPIP compared to LW.
Conclusion
LW mesh was associated with a long-term advantage with fewer postoperative complications for MIS repair. HW mesh was associated with higher CPIP risk following an open repair.
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- Titel
- Association of mesh weight with adverse outcomes: a cohort study including 123,880 inguinal hernia repairs
- Verfasst von
-
Brandon Cowan
Priscilla H. Chan
Sahil S. Patel
Heather A. Prentice
Kenneth Sucher
Elizabeth W. Paxton
Elliott R. Brill
Lavina Malhotra
Francisca M. Maertens
Gregory M. Heitmann
Rouzbeh Mostaedi
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03427-3
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