Hernia : the journal of hernias and abdominal wall surgery
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Review Meta Analysis
Open mesh versus non-mesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data [corrected].
The EU Hernia Trialists Collaboration was established to provide reliable evaluation of newer methods of groin hernia repair. It involved 70 investigators in 20 countries. ⋯ The review provides strong evidence that open mesh repair is associated with a reduction in the risk of recurrence of between 50% and 75%. There is also some evidence of quicker recovery and of lower rates of persisting pain following open mesh repair.
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Comparative Study
Intra-abdominal pressure: a reliable criterion for laparostomy closure?
Laparostomy is frequently performed in the surgical therapy of mechanical obstruction, peritonitis, or trauma to prevent abdominal compartment syndrome (ACS). Extended incisional hernia is inevitable when fascial closure is missed (up to 90% of cases). Intra-abdominal pressure (IAP) has not yet been evaluated as a criterion for the feasibility of fascial closure. ⋯ Fascial closure increased the IAP, which was accompanied by short-termed decrease in urine output. At these levels of IAP fascial closure appears to be harmless, but further prospective studies are needed to determine the critical level of IAP for allowing a safe repair of large fascial defects.