Mesh versus direct suture for the repair of umbilical and epigastric hernias.


COD: 03_2009_183-188 Categorie: ,

Cesare Stabilini, Mattis Stella, Marco Frascio , Luigi De Salvo, Rosario Fornaro, Giancarlo Larghero, Francesca Mandolfino, Fabrizio Lazzara, Ezio Gianetta

Ann. Ital. Chir., 2009; 80: 183-187

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BACKGROUND: The objective of this study was to evaluate outcomes of mesh versus primary suture procedures for repair
of anterior abdominal wall midline hernias.
RESULTS: Between 1995 and 2005, 98 patients (46 males) underwent repair of umbilical (69 cases) or epigastric (29
cases) hernias. Primary suture of the defect was performed in 34 cases (group 1). A polypropylene mesh was positioned
in 64 cases (group 2). Overall, mean aponeurotic defect diameter was 2.5 cm (range 0.5 ± 10 cm). Procedures were
carried out under local anesthesia in 76 instances (71% group 1 vs. 81% group 2). Complications occurring in group
2 comprised three seromas, one hematoma and one prosthetic infection. Follow up was scheduled yearly up to the fifth
postoperative year. Recurrence rate in group 1 was 14.7% compared to 3.1% in group 2 (logrank test p 0.0475).
CONCLUSIONS: Anterior preperitoneal mesh repair of abdominal wall midline hernias under local anesthesia seems to be
a safe and effective technique that can be performed as a day surgery procedure. A slightly increased risk of postoperative
local complications following mesh repair is offset by a reduced rate of recurrence in comparison to suture repair.


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