Patients and methods
Size of defect | Total | |||||||
---|---|---|---|---|---|---|---|---|
I (<1.5 cm) | II (1.5–3 cm) | III (>3 cm) | ||||||
n
| % |
n
| % |
n
| % |
n
| % | |
Mesh fixation | 852 | 56.76 | 4652 | 62.91 | 1918 | 82.25 | 7422 | 66.10 |
No mesh fixation | 649 | 43.24 | 2743 | 37.09 | 414 | 17.75 | 3806 | 33.90 |
Total | 1501 | 100.00 | 7395 | 100.00 | 2332 | 100.00 | 11,228 | 100.00 |
Size of defect | Total | |||||||
---|---|---|---|---|---|---|---|---|
I (<1.5 cm) | II (1.5–3 cm) | III (>3 cm) | ||||||
n
| % |
n
| % |
n
| % |
n
| % | |
Type of fixation | ||||||||
Suture | 121 | 14.20 | 760 | 16.34 | 446 | 23.25 | 1327 | 17.88 |
Tacker | 393 | 46.13 | 2219 | 47.70 | 956 | 49.84 | 3568 | 48.07 |
Glue | 331 | 38.85 | 1607 | 34.54 | 468 | 24.40 | 2406 | 32.42 |
Combination | 7 | 0.82 | 66 | 1.42 | 48 | 2.50 | 121 | 1.63 |
Total | 852 | 100.00 | 4652 | 100.00 | 1918 | 100.00 | 7422 | 100.00 |
Results
Unadjusted results
Mesh fixation | No mesh fixation |
p
| ||
---|---|---|---|---|
Age (years) | Mean ± STD | 57.4 ± 14.8 | 54.4 ± 15.7 | <0.001 |
BMI (kg/m²) | Mean ± STD | 25.9 ± 3.4 | 25.9 ± 3.3 | 0.573 |
Mesh size (cm²) | Mean ± STD | 151.1 ± 19.3 | 145.8 ± 15.6 | <0.001 |
n (7422) | % |
n (3806) | % |
p
| |
---|---|---|---|---|---|
ASA | |||||
I | 2601 | 35.04 | 1282 | 33.68 | 0.027 |
II | 3994 | 53.81 | 2037 | 53.52 | |
III/IV | 827 | 11.14 | 487 | 12.80 | |
Defect size (EHS) | |||||
I (<1.5 cm) | 852 | 11.48 | 649 | 17.05 | <0.001 |
II (1.5–3 cm) | 4652 | 62.68 | 2743 | 72.07 | |
III (>3 cm) | 1918 | 25.84 | 414 | 10.88 | |
Localization of defect (EHS) | |||||
Medial (M) | 2285 | 30.79 | 948 | 24.91 | <0.001 |
Lateral (L) | 4477 | 60.32 | 2298 | 60.38 | |
Combined (C) | 660 | 8.89 | 560 | 14.71 | |
Risk factors
| |||||
Overall | |||||
Yes | 1749 | 23.57 | 980 | 25.75 | 0.011 |
No | 5673 | 76.43 | 2826 | 74.25 | |
COPD | |||||
Yes | 321 | 4.32 | 196 | 5.15 | 0.051 |
No | 7101 | 95.68 | 3610 | 94.85 | |
Diabetes | |||||
Yes | 318 | 4.28 | 164 | 4.31 | 0.961 |
No | 7104 | 95.72 | 3642 | 95.69 | |
Aortic aneurysm | |||||
Yes | 22 | 0.30 | 9 | 0.24 | 0.705 |
No | 7400 | 99.70 | 3797 | 99.76 | |
Immunosuppression | |||||
Yes | 34 | 0.46 | 14 | 0.37 | 0.544 |
No | 7388 | 99.54 | 3792 | 99.63 | |
Corticoids | |||||
Yes | 50 | 0.67 | 23 | 0.60 | 0.711 |
No | 7372 | 99.33 | 3783 | 99.40 | |
Smoking | |||||
Yes | 643 | 8.66 | 470 | 12.35 | <.001 |
No | 6779 | 91.34 | 3336 | 87.65 | |
Coagulopathy | |||||
Yes | 74 | 1.00 | 37 | 0.97 | 1.000 |
No | 7348 | 99.00 | 3769 | 99.03 | |
Antiplatelet medication | |||||
Yes | 525 | 7.07 | 206 | 5.41 | <0.001 |
No | 6897 | 92.93 | 3600 | 94.59 | |
Cumarin medication | |||||
Yes | 133 | 1.79 | 52 | 1.37 | 0.100 |
No | 7289 | 98.21 | 3754 | 98.63 |
Mesh fixation | No mesh fixation |
p
| |||
---|---|---|---|---|---|
n
| % |
n
| % | ||
Recurrent hernia (1-year follow-up: 100 %) | |||||
Yes | 65 | 0.88 | 42 | 1.10 | 0.259 |
No | 7357 | 99.12 | 3764 | 98.90 |
Multivariable analysis
Parameter |
p value | Variables | OR | 95 %-CI | |
---|---|---|---|---|---|
Localization of defect (EHS) | <0.001 | Combined versus medial | 1.137 | 0.656 | 1.970 |
Lateral versus medial | 0.463 | 0.303 | 0.707 | ||
Risk factors: COPD/smoking | 0.097 | Yes versus no | 0.556 | 0.278 | 1.111 |
BMI (five-point OR) | 0.109 | 1.240 | 0.953 | 1.613 | |
Size of mesh (ten-point OR) | 0.192 | 0.929 | 0.832 | 1.038 | |
Size of defect (EHS) | 0.383 | I (<1.5 cm) versus III (>3 cm) | 1.330 | 0.694 | 2.546 |
II (1.5–3 cm) versus III (>3 cm) | 0.914 | 0.558 | 1.499 | ||
Fixation of mesh | 0.399 | No fixation versus fixation | 1.194 | 0.791 | 1.800 |
Risk factors (others)a
| 0.408 | Yes versus no | 1.269 | 0.721 | 2.234 |
ASA | 0.720 | II versus I | 1.106 | 0.683 | 1.791 |
III/IV versus I | 1.352 | 0.650 | 2.812 | ||
Age [10-year OR] | 0.869 | 1.013 | 0.868 | 1.183 |
Subgroup analysis
Medial | Lateral | Combined |
p
| ||||
---|---|---|---|---|---|---|---|
n
| % |
n
| % |
n
| % | ||
Recurrence | |||||||
Yes | 44 | 1.36 | 44 | 0.65 | 19 | 1.56 | <0.001 |
No | 3190 | 98.64 | 6732 | 99.35 | 1201 | 1.56 |
Mesh fixation | No mesh fixation |
p
| |||
---|---|---|---|---|---|
n
| % |
n
| % | ||
Recurrence | |||||
Yes | 25 | 1.09 | 19 | 2.00 | 0.046 |
No | 2260 | 98.91 | 929 | 98.00 |
Suture | Tacker | Glue | Combined |
p
| |||||
---|---|---|---|---|---|---|---|---|---|
n
| % |
n
| % |
n
| % |
n
| % | ||
Recurrence | |||||||||
Yes | 4 | 0.97 | 16 | 1.34 | 5 | 0.79 | 0 | 0 | 0.746 |
No | 407 | 99.03 | 1182 | 98.66 | 627 | 99.21 | 44 | 100.00 |
Fixation |
p
| |||
---|---|---|---|---|
Mesh fixation (n = 2285) | No Mesh fixation (n = 948) | |||
Mesh size (cm2) | Mean ± STD | 151.0 ± 21.1 | 145.2 ± 19.0 | <0.001 |
Mesh fixation | No mesh fixation |
p
| |||
---|---|---|---|---|---|
n
| % |
n
| % | ||
Type of meshes | |||||
Other <5 % | 1079 | 47.22 | 416 | 43.88 | <0.001 |
Ultrapro | 604 | 26.43 | 80 | 8.44 | |
Parietene ProGrip | 6 | 0.26 | 186 | 19.62 | |
TiMesh light | 184 | 8.05 | 107 | 11.29 | |
3DMax Light Mesh | 61 | 2.67 | 135 | 14.24 | |
Optilene Mesh LP | 351 | 15.36 | 24 | 2.53 |