Page 55 - Prevention and Treatment of Incisional Hernia- New Techniques and Materials

Of 545 patients, follow-up assessments were done by clinical and radiological examination in 338 (62%) patients, by radiological examination in 76 (14%), and by physical examination in 131 (24%) patients. Follow-up methods were similar between groups. 1 year postoperatively, 57 (21%) of 277 patients had incisional hernia in the large bites group and 35 (13%) of 268 patients had incisional hernia in the small bites group (p=0•0220; adjusted odds ratio [OR] 0•52, 95% CI 0•31–0•87; p=0•0131). No subgroup e ects were identi ed; all p values for interaction tests were greater than 0•20. In patients followed-up by both physical and radiological examination, incisional hernia was identi ed in 43 (49%) of 87 patients by both physical and radiological examination, in 41 (47%) of 87 solely by radiological examination, and in 3 (3%) of 87 solely by physical examination. In patients with incisional hernia, the mean fascial defect was 3•4 cm (SD 4•4). The size of the hernia defects did not di er signi cantly between groups (data not shown). Incisional hernias diagnosed by radiological examination alone were not signi cantly smaller than those diagnosed by both physical and radiological examination (mean 2•4 cm [SD 4•0] vs 4•2 cm [0•5]; p=0•0650.
Almost half of patients had postoperative complications, the incidence of which did not di er signi cantly between groups (table 3). Readmission rates and adverse events did not di er signi cantly between groups (table 3). Pain scores on the visual analogue scale did not di er signi cantly between groups in the rst postoperative week (data not shown). 452 (94%) of 483 patients completed the SF-36 questionnaire and the EQ-5D questionnaire 12 months post-operatively. None of the SF-36 subdomains, the mental component summary (MCS) score, the physical component summary (PCS), or EQ-5D dimensions di ered signi cantly between groups at 12 months (data not shown). Patients who developed incisional hernia during follow-up had lower general health SF-36 scores than did those without incisional hernia 12 months post-operatively (mean 60•16 [SD 18•27] vs 64•84 [48•70]; p=0•0326) and reported more problems in EQ-5D dimension of mobility (1•46 [1•06] vs 1•36 [0•46]; p=0•0318). We noted no signi cant di erences for the other SF-36 domains, the MCS, the PCS, EQ-5D dimensions, or overall health status on VAS (data not shown).
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STITCH trial
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