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[Bassini operation with polyglycolic acid or polyester. A prospective randomized study of 300 cases]
N Fuchsjäger1, A Feichter, A Hirbawi
1Chirurgische Abteilung, St. Josef-Krankenhaus Wien.
Summary
Polyglycolic acid (PGA) mesh showed a higher hernia recurrence rate compared to polyester mesh in Bassini hernia repair. This difference was significant in men and patients with specific risk factors.
Area of Science:
- Surgical Innovation
- Biomaterials in Surgery
- Hernia Repair Techniques
Background:
- Bassini hernia repair is a common surgical procedure.
- Polyglycolic acid (PGA) and polyester are synthetic materials used in surgical meshes.
- Recurrence rates are a key metric for evaluating hernia repair outcomes.
Purpose of the Study:
- To compare the recurrence rates of polyglycolic acid (PGA) mesh versus polyester mesh in Bassini hernia repair.
- To identify patient subgroups where one mesh material may be superior to the other.
Main Methods:
- A prospectively randomized trial was conducted.
- Patients undergoing Bassini hernia repair were assigned to either PGA or polyester mesh.
- Recurrence rates were assessed after a median observation period of 2 years.
Main Results:
- Overall recurrence rate was 12.0% for PGA versus 7.0% for polyester (statistically insignificant).
- In men, recurrence rates were 15.4% for PGA and 6.4% for polyester (statistically significant).
- Risk factors like obesity, bronchitis, recurrent hernia, and large hernial sac size (>8 cm) showed higher recurrence with PGA, especially the latter.
Conclusions:
- Polyester mesh demonstrated a lower recurrence rate than PGA mesh in Bassini hernia repair.
- PGA mesh may be less suitable for men and patients with specific risk factors, particularly those with large hernial sacs.