Wednesday, February 19, 2014 (HealthDay News)-Use Surgical Mesh Instead stitch A new study suggests that simply repairing an abdominal hernia is less likely to cause the problem to recur.
However, the use of mesh is associated with other surgical risks, including infection, the researchers said.
“When repairing a primary abdominal hernia, mesh strengthening gives the best long-term results in most situations,” said Mike Liang, Ph.D. researcher and assistant professor of surgery at the University of Texas Health Sciences Center in Houston. The doctor said.
abdomen hernia Occurs when Intestines It swells from the weak point of the abdominal wall.Surgeons often patch using loosely woven sheets of flexible mesh Weaknesses Or, instead of just stitching, close the hole.
The advantage of the mesh is that it allows the tension created by the repair to spread throughout the abdominal wall, allowing the patient to move normally after surgery, says Stephen Hodget, a general surgeon at Baptist Health in Jacksonville. Said the doctor. Hula.
Synthetic, according to Hodgett plastic The mesh adds about $ 50 to $ 100 to the cost of the procedure. The biological mesh could add more than $ 8,000, he said.
Abdomen of more than 350,000 people in the United States hernia According to the background information of the study, repair surgery is performed every year. Of these, 75% are known as primary ventral hernias (usually weakened abdominal walls in the navel).
According to Hodget, there are two repair options. One involves open surgery, repairing hernias with a mesh, stitch.. The disadvantage of this procedure is that it increases the risk of infection. for that reason, obesity He said that patients or others, whose primary concern is the risk of infection.
Another minimally invasive surgery uses only stitches. The smaller incision reduces the chance of infection, but increases the risk of recurrence, Hodget said.
“Hernia repair is a complex patient decision, but there are great options. It seems that the ability to repair hernias is evolving as we try to reduce recurrence and complication rates to zero,” Hodget said. ..
Dr. Michael Castellano, director of the Hernia Program at Staten Island University Hospital in New York City, said he has long believed that the use of mesh generally reduces recurrence. He said the study confirmed this belief.
“The infection rates in both groups are essentially the same, but Celoma [pockets of clear fluid that develop after surgery] “Mesh is more expensive,” Castellano added. We are confident that as technology improves, so will the seroma rate. ”
Published online on February 19th for research JAMA surgery, Liang’s team analyzed data from nine studies conducted between 1980 and 2012 and compared the use of mesh with the use of stitches only. In total, it included 637 mesh repairs and 1,145 suture repairs.
The recurrence rate was only 2.7% when the mesh was used for stitching, compared to 8.2% for stitching alone.
However, the use of mesh increased the odds of seromas-7.7 percent compared to 3.8 percent-researchers found. Incision infections were also slightly more common on mesh, 7.3% vs. 6.6%.
The authors suggest that further research is needed to determine if one surgical procedure is clearly superior to the other.
Dr. Robert Andrews, director of emergency care at Lenox Hill Hospital in New York City, said: ..
“I don’t think the safe message to the patient will change. Talk to an experienced surgeon to discuss your particular case,” Andrews said.
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Source: Mike Liang, MD, Associate Professor, Surgery, University of Texas Health Science Center. Stephen Hodget, MD, General Surgeon, Baptist Health, Jacksonville, Florida; Doctor of Medicine, Robert Andrews, Director of Emergency Care, Lenox Hill Hospital, New York City. Michael Castellano, MD, Director, Hernia Program, Staten Island University Hospital, New York City. February 19, 2014, JAMA surgery,online
Hernia Repair Mesh Reduces Recurrence, Studies Suggest
Source link Hernia Repair Mesh Reduces Recurrence, Studies Suggest