LAUSR

The aim of this retrospective study was to compare open small- and medium-sized ventral hernia repair with flat patch mesh versus three-dimensional mesh (plug) in terms of recurrence and complication rates. The medical records of 300 patients who underwent ventral hernia repair using flat mesh versus plug between January 2010 to December 2015 were reviewed. All patients were followed up after 1 month, 3 month and 1 year. The rate of recurrence, and short-term postoperative complications such as incidence of Surgical Site Infections (SSIs), hematoma and seroma were evaluated. Short-term follow-up data were available for all patients. The first group was composed of 150 patients that were treated with plug (60% presented umbilical hernia and 40% presented epigastric hernia). The second group was composed of 150 patients that were treated with flat mesh (68% presened umbilical hernia and 32% presented epigastric hernia). The majority of postoperative complications were wound related, representing superficial SSI or seroma. Our results showed a statistically significant reduction of SSIs [3 (2%) vs 13 (8.6%); p = 0.038] and seroma [2 (1.3%) vs 12 (8%); p = 0.030] in the group of patients treated with plugs. There was no statistically significant difference in hernia recurrences. Usage of plugs represents a feasible and safe technique that significantly lowers the incidence of complications. Furthermore, compared to flat mesh, plugs displayed non-inferiority in terms recurrence. Further, well-designed clinical trials could be realized to investigate possible applications of plugs for umbilical and epigastric hernias repair.