Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair

L M Van den Dop; M M J Van Rooijen; T Tollens; L N Jørgensen; T S De Vries-Reilingh; G Piessen; F Köckerling; M Miserez; M Dean; F Berrevoet; B Dousset; H L Van Westreenen; F Gossetti; G W M Tetteroo; Andreas Koch; M F Boomsma; J F Lange; J Jeekel

doi:10.1097/AS9.0000000000000366

Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair

L M Van den Dop, M M J Van Rooijen, T Tollens, L N Jørgensen, T S De Vries-Reilingh, G Piessen, F Köckerling, M Miserez, M Dean, F Berrevoet, B Dousset, H L Van Westreenen, F Gossetti, G W M Tetteroo, Andreas Koch, M F Boomsma, J F Lange, J Jeekel

Digestive Diease Center BFH

Abstract

OBJECTIVE: To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh.

SUMMARY BACKGROUND DATA: Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12-18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce.

METHODS: Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0-10].

RESULTS: In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55-64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9-24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0-2).

CONCLUSIONS: Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.

Original language	English
Journal	Annals of surgery open : perspectives of surgical history, education, and clinical approaches
Volume	4
Issue number	4
Pages (from-to)	e366
ISSN	2691-3593
DOIs	https://doi.org/10.1097/AS9.0000000000000366
Publication status	Published - Dec 2023

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10.1097/AS9.0000000000000366

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Van den Dop, L. M., Van Rooijen, M. M. J., Tollens, T., Jørgensen, L. N., De Vries-Reilingh, T. S., Piessen, G., Köckerling, F., Miserez, M., Dean, M., Berrevoet, F., Dousset, B., Van Westreenen, H. L., Gossetti, F., Tetteroo, G. W. M., Koch, A., Boomsma, M. F., Lange, J. F., & Jeekel, J. (2023). Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair. Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 4(4), e366. https://doi.org/10.1097/AS9.0000000000000366

Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair. / Van den Dop, L M; Van Rooijen, M M J; Tollens, T et al.
In: Annals of surgery open : perspectives of surgical history, education, and clinical approaches, Vol. 4, No. 4, 12.2023, p. e366.

Research output: Contribution to journal › Journal article › Research › peer-review

Van den Dop, LM, Van Rooijen, MMJ, Tollens, T, Jørgensen, LN, De Vries-Reilingh, TS, Piessen, G, Köckerling, F, Miserez, M, Dean, M, Berrevoet, F, Dousset, B, Van Westreenen, HL, Gossetti, F, Tetteroo, GWM, Koch, A, Boomsma, MF, Lange, JF & Jeekel, J 2023, 'Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair', Annals of surgery open : perspectives of surgical history, education, and clinical approaches, vol. 4, no. 4, pp. e366. https://doi.org/10.1097/AS9.0000000000000366

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title = "Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair",

abstract = "OBJECTIVE: To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh.SUMMARY BACKGROUND DATA: Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12-18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce.METHODS: Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0-10].RESULTS: In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55-64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9-24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0-2).CONCLUSIONS: Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.",

author = "{Van den Dop}, {L M} and {Van Rooijen}, {M M J} and T Tollens and J{\o}rgensen, {L N} and {De Vries-Reilingh}, {T S} and G Piessen and F K{\"o}ckerling and M Miserez and M Dean and F Berrevoet and B Dousset and {Van Westreenen}, {H L} and F Gossetti and Tetteroo, {G W M} and Andreas Koch and Boomsma, {M F} and Lange, {J F} and J Jeekel",

note = "Copyright {\textcopyright} 2023 The Author(s). Published by Wolters Kluwer Health, Inc.",

year = "2023",

month = dec,

doi = "10.1097/AS9.0000000000000366",

language = "English",

volume = "4",

pages = "e366",

journal = "Annals of surgery open : perspectives of surgical history, education, and clinical approaches",

issn = "2691-3593",

number = "4",

}

TY - JOUR

T1 - Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair

AU - Van den Dop, L M

AU - Van Rooijen, M M J

AU - Tollens, T

AU - Jørgensen, L N

AU - De Vries-Reilingh, T S

AU - Piessen, G

AU - Köckerling, F

AU - Miserez, M

AU - Dean, M

AU - Berrevoet, F

AU - Dousset, B

AU - Van Westreenen, H L

AU - Gossetti, F

AU - Tetteroo, G W M

AU - Koch, Andreas

AU - Boomsma, M F

AU - Lange, J F

AU - Jeekel, J

PY - 2023/12

Y1 - 2023/12

N2 - OBJECTIVE: To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh.SUMMARY BACKGROUND DATA: Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12-18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce.METHODS: Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0-10].RESULTS: In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55-64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9-24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0-2).CONCLUSIONS: Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.

AB - OBJECTIVE: To assess the 5-year recurrence rate of incisional hernia repair in Ventral Hernia Working Group (VHWG) 3 hernia with a slowly resorbable mesh.SUMMARY BACKGROUND DATA: Incisional hernia recurs frequently after initial repair. In potentially contaminated hernia, recurrences rise to 40%. Recently, the biosynthetic Phasix mesh has been developed that is resorbed in 12-18 months. Resorbable meshes might be a solution for incisional hernia repair to decrease short- and long-term (mesh) complications. However, long-term outcomes after resorption are scarce.METHODS: Patients with VHWG grade 3 incisional midline hernia, who participated in the Phasix trial (Clinilcaltrials.gov: NCT02720042) were included by means of physical examination and computed tomography (CT). Primary outcome was hernia recurrence; secondary outcomes comprised of long-term mesh complications, reoperations, and abdominal wall pain [visual analogue score (VAS): 0-10].RESULTS: In total, 61/84 (72.6%) patients were seen. Median follow-up time was 60.0 [interquartile range (IQR): 55-64] months. CT scan was made in 39 patients (68.4%). A recurrence rate of 15.9% (95% confidence interval: 6.9-24.8) was calculated after 5 years. Four new recurrences (6.6%) were found between 2 and 5 years. Two were asymptomatic. In total, 13/84 recurrences were found. No long-term mesh complications and/or interventions occurred. VAS scores were 0 (IQR: 0-2).CONCLUSIONS: Hernia repair with Phasix mesh in high-risk patients (VHWG 3, body mass index >28) demonstrated a recurrence rate of 15.9%, low pain scores, no mesh-related complications or reoperations for chronic pain between the 2- and 5-year follow-up. Four new recurrences occurred, 2 were asymptomatic. The poly-4-hydroxybutyrate mesh is a safe mesh for hernia repair in VHWG 3 patients, which avoids long-term mesh complications like pain and mesh infection.

U2 - 10.1097/AS9.0000000000000366

DO - 10.1097/AS9.0000000000000366

M3 - Journal article

C2 - 38144487

SN - 2691-3593

VL - 4

SP - e366

JO - Annals of surgery open : perspectives of surgical history, education, and clinical approaches

JF - Annals of surgery open : perspectives of surgical history, education, and clinical approaches

IS - 4

ER -

Five-Year Follow-Up of a Slowly Resorbable Biosynthetic P4HB Mesh (Phasix) in VHWG Grade 3 Incisional Hernia Repair

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