Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P046: VENTRAL INCISIONAL HERNIA REPAIR USING THE RIVES–STOPPA TECHNIQUE WITH FIBRIN GLUE FOR MESH FIXATION DOES NOT INCREASE RATES OF SEROMA FORMATION OR HERNIA RECURRENCE.
Celia R Ledet, MD; Davis Santos, MD; Xuemei Wang, MS; Heather Gibson, PAC; Angela Limmer, PAC; Brian Badgwell, MD, MS; University of Texas MD Anderson Cancer Center
Introduction: Open ventral incisional hernia repairs with mesh reduce hernia recurrence rates to less than 10%. The Rives-Stoppa retro rectus hernia repair is becoming standard of care for mesh repair for complex incisional hernias. Retro rectus mesh fixation using trans fascial sutures has traditionally been used to stabilize mesh; however, fibrin sealant fixation has been used as an alternative to reduce pain. In addition, fibrin sealant may reduce operative time and seroma formation. The primary objective of this study is to evaluate hernia recurrence rates and seroma formation between cancer patients who undergo open Rives Stoppa incisional hernia repair using trans fascial suture versus fibrin glue for mesh fixation.
Methods: A retrospective review of a prospectively maintained database at a single institution consisting of Rives-Stoppa ventral incisional hernias was performed. Fisher’s exact test was used to assess differences in hernia recurrence and seroma formation rates between the trans facial and fibrin glue mesh fixation cohorts. Using a neutral prior, Bayesian analysis was performed to look at the posterior probability of reduced hernia recurrence given retro rectus repair with fibrin glue fixation.
Results: A total of 45 patients were included in the analysis. Patient demographics were similar between both groups. There was no statistically significant difference in seroma formation requiring IR drainage between the fibrin glue vs. trans fascial suture group (5% vs. 9%, p-value= 1.00). The odds of having a hernia recurrence was four times higher in the trans fascial suture group, compared to the fibrin glue fixation group, but this was not statistically significant (OR 0.35, p-value =0.35; 95% CI: 0.025 – 2.46). The Bayesian posterior probability of hernia recurrence suggests that there is a 90% probability that the hernia recurrence rate is higher in the trans fascial suture group compared to the fibrin glue fixation group.
Conclusion: Patients undergoing ventral incisional hernia repair with retro rectus mesh placement may benefit from reduced hernia recurrence using fixation with fibrin glue as an alternative to trans fascial suture fixation. Although limited by sample size, there are no statistically significant differences in hernia recurrence. However the high probability of reducing the odds of hernia recurrence with fibrin glue fixation warrants a prospective randomized, multi-institutional clinical trial.
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