Ann Surg Treat Res.  2017 Dec;93(6):322-330. 10.4174/astr.2017.93.6.322.

Comparison of partially-absorbable lightweight mesh with heavyweight mesh for inguinal hernia repair: multicenter randomized study

Affiliations
  • 1Department of Surgery, Daehang Hospital, Seoul, Korea.
  • 2Department of Surgery, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea. cutdown@eulji.ac.kr

Abstract

PURPOSE
Prosthetic mesh is widely used for inguinal hernia repair; however, pain and stiffness can develop. This study was a prospective, multicenter, single-blind, randomized trial to assess postoperative pain and quality of life according to mesh type after inguinal hernia repair.
METHODS
Forty-seven patients who underwent Lichtenstein repair for unilateral inguinal hernia with prosthetic mesh were enrolled and randomly allocated to the partially-absorbable lightweight mesh (LW group, n = 24) or heavyweight mesh group (HW group, n = 23). Data were collected using a visual analogue scale (VAS), Carolinas Comfort Scale (CCS), and Activities Assessment Scale (AAS) at screening and postoperative day 1, 7, 90, and 120; foreign body sensation, sense of stiffness, and sense of pull during activity were also evaluated.
RESULTS
There were no significant differences in patients' demographics and clinical characteristics between groups. The VAS at day 90 was significantly lower in the LW group (0.46 ± 0.78 vs. 0.96 ± 0.82, P = 0.027). The CCS and AAS were significantly lower in the LW group at day 1 (51.33 ± 20.29 vs. 64.65 ± 22.64, P = 0.047 and 39.83 ± 9.88 vs. 46.43 ± 7.82, P = 0.015, respectively). Foreign body sensation was significantly lower in the LW group at day 120 (4.2% vs. 30.4 %, P = 0.023), as was sense of stiffness (P = 0.023). The sense of pull during activity was lower in the LW group at day 90 and 120 (P = 0.012 and P = 0.022, respectively). There was no recurrence or serious complication during follow-up.
CONCLUSION
Partially-absorbable lightweight prosthetic mesh can be used for inguinal hernia repair safely and improve functional outcomes and quality of life after surgery.

Keyword

Inguinal hernia; Surgical mesh; Quality of lifes

MeSH Terms

Demography
Follow-Up Studies
Foreign Bodies
Hernia, Inguinal*
Humans
Mass Screening
Pain, Postoperative
Prospective Studies
Quality of Life
Recurrence
Sensation
Surgical Mesh

Figure

  • Fig. 1 Study design and enrollment. Proflex (Samyang, Seoul, Korea), Marlex (Bard, Murray Hill, NJ, USA).

  • Fig. 2 Partially absorbable lightweight mesh mesh. (A) Gross morphology. (B) Segmented pie form monofilament mesh that is a mixture of nonsoluble polypropylene and poliglecaprone (PGA-PCL). (C) Electron microscope image of mesh before absorption; segmented pie monofilament. (D) Electron microscope image of mesh after degradation; polypropylene multistrand.


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