Open AccessDifferential recurrence after laparoscopic incisional hernia repair: importance of a nationwide registry‐based mesh surveillance
Author(s) -
Helgstrand F.,
Thygesen L. C.,
Bisgaard T.,
Jørgensen L. N.,
FriisAndersen H.
Publication year - 2020
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.11562
Subject(s) - medicine , hernia , surgery , odds ratio , incisional hernia , surgical mesh , hazard ratio , hernia repair , laparoscopy , complication , laparoscopic surgery , cohort study , general surgery , confidence interval
Background I dentification of suboptimal mesh products is essential to improve the outcome after hernia surgery. This study investigated whether a national clinical database combined with administrative registries may serve as a tool for postmarketing evaluation of mesh products for hernia surgery. Methods This was a propensity score‐matched case–control cohort study comparing outcomes in patients undergoing laparoscopic incisional hernia repair with either one particular mesh or any other synthetic mesh. Data on patients registered in the Danish Ventral Hernia Database between 2010 and 2016 were combined with administrative data from the Danish National Patient Registry. The primary outcome was operation for recurrence. Secondary outcomes were 30‐day readmission, 30‐day reoperation for complications (excluding hernia recurrence), and mortality after 30 and 90 days. Results In total, 740 patients who underwent repair with one particular mesh were matched with 1479 patients who received any other synthetic mesh. The rate of repair for hernia recurrence was significantly higher in the particular mesh group than in the reference group: 12·8 versus 6·3 per cent respectively (hazard ratio 2·09, 95 per cent c.i. 1·57 to 2·79; P < 0·001). Use of the particular mesh increased the risk of readmission (odds ratio (OR) 1·53, 1·16 to 2·01; P = 0·002) and reoperation for a complication (OR 1·60, 1·03 to 2·47, P = 0·030). No difference in mortality was found. Conclusion Clinical registries with prospectively collected data can provide long‐term surveillance of commercial mesh. Laparoscopic incisional hernia repair with one particular mesh was associated with an increased rate of short‐term complications and double the risk of repair for recurrence.