Tension-free mesh versus sutured repair in incisional hernia surgery.

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Yahia Al-Tayeb Al-Arabi2
Bin Tayair SA1

Abstract

AbstractAbstractObjective. The objective of this study is to evaluate the outcomes of tension-free mesh and sutured repairs in incisional hernia surgery.Patients & methods: Between September 2004 and December 2007, a randomized controlled study had been conducted in two main hospitals in Hadhramout-Yemen in which 415 patients with primary incisional hernias were randomly allocated to either suture or mesh repair. The primary outcome measure was hernia recurrence. The secondary outcome measures were operative time, patients’ comfort, analgesic requirement, hospital stay, rehabilitation, and complications. The patients were followed up for 3 years.Result: The recurrence rate was 4.3% in the mesh group and 27.5 % in the sutured group. The patients in the mesh group have prolonged operative time (61.16 minutes vs 59.13 minutes), but shorter hospital stay (2.8 days comparable with 3.1days), and earlier return to normal activities (23.8 days vs 26.6 days). Suturedrepair showed greater levels of pain (p<0.001,and more consumption of parenteral (93.7% vs 65.4%) and oral analgesics (63.8% versus 38%). The post-operative complications were comparable in both groups except, in the sutured group more patients, presented with chronic pain, (13.0% versus 4.3%). Conclusion: Tension-free repair of incisional hernia is safe and effective. It is associated with lower recurrence rate, lesser postoperative pain, lesser consumption of analgesic drugs, and earlier rehabilitation, than suturedrepair. 

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