Hernia : the journal of hernias and abdominal wall surgery
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The purpose of this study was to establish long-term outcome after elective adult umbilical hernia (AUH) repair. ⋯ AUH repair could be performed with low early and long-term complication rates, with low recurrence rates also after non-mesh repairs. A substantial cohort of patients will unnecessary be implanted with meshes if mesh-reinforced repairs should be used on a routine basis, that is, 16 surplus meshes to prevent one recurrence in the present study. We recommend a tailored approach to AUH repair: suture-based methods with defects smaller than 2 cm and mesh-based repairs considered if larger than that.
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Review Meta Analysis
Systematic review and meta-analysis of prophylactic mesh placement for prevention of incisional hernia following midline laparotomy.
Incisional hernia is a common long-term complication after laparotomy. This study investigated whether prophylactic mesh reinforcement of laparotomy reduced the rate of incisional hernia, with emphasis on trial design and quality. ⋯ Mesh reinforcement of laparotomy significantly reduced the rate of incisional hernia in high-risk patients. However, poor assessment of secondary outcomes limits applicability; routine placement in all patients cannot yet be recommended. More evidence regarding the rates of adverse events, cost-benefits and quality of life are needed.
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Randomized Controlled Trial
The effect of preemptive analgesia with bupivacaine on postoperative pain of inguinal hernia repair under spinal anesthesia: a randomized clinical trial.
In the absence of any study on the use of bupivacaine as a long acting local anesthetic for the purpose of inducing preemptive analgesia in patients undergoing inguinal hernia repair under spinal anesthesia, this study was conducted to provide some evidence for possible benefits of such practice. ⋯ The pre-operative local infiltration of bupivacaine reduces pain, nausea, vomiting and opioid use in the first 24 h after inguinal hernia surgery under spinal anesthesia. Therefore, further evaluation of the efficacy of this technique as a modality of preemptive analgesia is suggested.
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The primary aim of the present study was to investigate risk factors for readmission after elective umbilical and epigastric hernia repair and secondarily to evaluate causes for readmission. ⋯ The risk for 30-day readmission after umbilical or epigastric hernia repairs was mainly because of surgical complications. Open mesh repair reduced the risk for readmission in open repairs; no specific approach was found to reduce readmission after laparoscopic repair.
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Clinical Trial
Open preperitoneal mesh repair of inguinal hernias using a mesh with nitinol memory frame.
To prospectively evaluate the use of a continuous Nitinol containing memory frame patch during a TIPP-technique in the open repair of inguinal and femoral hernias. ⋯ A nitinol memory frame containing mesh is a valuable tool to achieve complete deployment of a large pore mesh in a TIPP repair for inguinal hernias with acceptable morbidity and a low recurrence rate.