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OC-057 PREVENTION OF INCISIONAL HERNIAS BY PROPHYLACTIC MESH-AUGMENTED REINFORCEMENT OF MIDLINE LAPAROTOMIES FOR ABDOMINAL AORTIC ANEURYSM TREATMENT. 5-YEAR FOLLOW-UP OF A RANDOMIZED CONTROLLED TRIAL
Dewulf, M; Muysoms, F; Vierendeels, T et al.
2022In British Journal of Surgery, 109 (Supplement_7), p. 18
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Keywords :
Surgery
Abstract :
[en] Abstract Introduction The incidence of incisional hernias (IHs) after open repair of an abdominal aortic aneurysm (AAA) is high. Several randomized controlled trials have reported favorable results with the use of prophylactic mesh to prevent IHs, without increasing complications. In this analysis we report on the results of the 60-month follow-up of the PRIMAAT trial (Ann Surg 2016; 263(4): 638–45). Methods In a prospective, multicenter, open label, randomized design, patients were randomized between prophylactic retrorectus mesh reinforcement (MESH group), and primary closure of their midline laparotomy after open AAA repair (NOMESH group). This article reports on the results of clinical follow-up after 60 months. If performed, ultrasonography or computed tomography were used for the diagnosis of IHs. Results Of the 120 randomized patients, 114 were included in the intention-to-treat analysis. Thirty-three patients in the NOMESH group (33/58–56.9%) and 34 patients in the MESH group (34/56–60.7%) were evaluated after 5 years. The cumulative incidence of IHs in the NOMESH group was 32.9% after 24 months and 49.2% after 60 months. No incisional hernias were diagnosed in the MESH group. In the NOMESH group, 21.7% (5/23) underwent reoperation within 5 years due to an IH. Conclusion Prophylactic retrorectus mesh reinforcement after midline laparotomy for the treatment of AAAs safely and effectively decreases the rate of IHs. The cumulative incidence of IHs after open AAA repair, when no mesh is used, continues to increase during the first 5 years after surgery, which leads to a substantial rate of hernia repairs.
Disciplines :
Surgery
Author, co-author :
Dewulf, M;  Surgery, MUMC+ , Maastricht , Netherlands
Muysoms, F;  Surgery , AZ Maria Middelares, Gent , Belgium
Vierendeels, T;  Surgery , ASZ, Aalst , Belgium
Huyghe, M;  Surgery , AZ Monica, Antwerpen , Belgium
Miserez, M;  Surgery , UZ Leuven, Leuven , Belgium
Ruppert, M;  Surgery , UZA, Antwerpen , Belgium
Van Bergen, L;  Surgery , UZA, Antwerpen , Belgium
Berrevoet, F;  Surgery , UZ Gent, Gent , Belgium
Detry, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation
Language :
English
Title :
OC-057 PREVENTION OF INCISIONAL HERNIAS BY PROPHYLACTIC MESH-AUGMENTED REINFORCEMENT OF MIDLINE LAPAROTOMIES FOR ABDOMINAL AORTIC ANEURYSM TREATMENT. 5-YEAR FOLLOW-UP OF A RANDOMIZED CONTROLLED TRIAL
Publication date :
01 October 2022
Event name :
44th Annual International Congress
Event organizer :
European Hernia Society
Event date :
du 18 au 21 octobre 2021
Audience :
International
Journal title :
British Journal of Surgery
ISSN :
0007-1323
eISSN :
1365-2168
Publisher :
Oxford University Press (OUP)
Special issue title :
Abstracts of the European Hernia Society 44th Annual International Congress, 18-21 October 2022, Manchester, UK
Volume :
109
Issue :
Supplement_7
Pages :
vii18
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 23 October 2022

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