Surgery: Current Research

ISSN - 2161-1076


Open Treatment of Abdominal Wall Hernias: Mesh Repair is Superior to Suture Repair and Onlay Mesh is Better than Sublay Mesh Five-Year Multicentric, Prospective, Randomised Clinical Trial

József Baracs *,G.S.Sajjadi ,D. Kelemen ,O.P. Horvath ,A. Vereczkei ,G. Weber

Background: The aim of study was to compare the results of different surgical modalities/mesh (onlay/sublay position) and suture repair in treatment of abdominal hernias.

Methods: According to the size of hernia gate patients were divided into two groups: small hernias (hernia gate between 5-25 cm2) and large hernias (gate > 25 cm2). In these two groups patients were randomized according to the surgical procedure: in group ‘A’ suture vs. mesh repair and in group ‘B’ onlay vs. sublay mesh reconstruction.

Results: n = 734. In small hernia group significantly higher recurrences occurred after suture repair than in mesh repair (27.2% vs. 8.3% – p < 0.001). In large hernia group onlay mesh reconstruction showed significantly better results than sublay mesh repair, recurrence rate was much lower in onlay group (12.2% vs. 20.1% – p = 0.038). Wound infection presence was more significant (p=0.029) in onlay group.

Conclusion: Among small hernias mesh repair provides better results than suture repair. In case of large hernia group the onlay mesh repair is significantly superior to the sublay repair, but the infection rate is much higher with only one.