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. 2023 Oct 13:36:e1766.
doi: 10.1590/0102-672020230048e1766. eCollection 2023.

ONLAY VERSUS RIVES-STOPPA TECHNIQUES IN THE TREATMENT OF INCISIONAL HERNIAS

Alana Kezya Pereira-Rodrigues  1 , João Victor Santos Maceio-Da-Graça  1 , Erik Matheus Lemos de Oliveira Ferreira  1 , Claudio Claudino Alves-Almeida  1
Affiliations

ONLAY VERSUS RIVES-STOPPA TECHNIQUES IN THE TREATMENT OF INCISIONAL HERNIAS

Alana Kezya Pereira-Rodrigues et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Background: In the surgical correction of large incisional hernias, the use of a prosthesis is essential in most cases regardless of the technique chosen. The preference is for the polypropylene prosthesis.

Aims: To compare the onlay and Rives-Stoppa techniques in the correction of incisional hernias, their immediate results, complications, advantages, and disadvantages.

Methods: Two groups of patients with incisional hernias were analyzed, submitted to the onlay (19 patients) and Rives-Stoppa (17 patients) techniques, and that used polypropylene prostheses. General epidemiological variables, perioperative data variables, and postoperative complications were assessed.

Results: The patients' epidemiologic profile was similar between both groups. The majority were women (58.4%), with a mean age of 65.5 years and a previous mean body mass index of 41.5 kg/m². The Rives-Stoppa technique was employed in most patients (52.7%). Those submitted to the onlay technique had longer abdominal drainage time and longer hospital stay, as well as a higher incidence of seromas and surgical wound infection.

Conclusions: The incisional herniorrhaphy technique with the placement of a pre-peritoneal polypropylene mesh by the Rives-Stoppa technique was superior to the onlay due to lower rates of drain use, hospital stay, and postoperative complications.

RACIONAL:: Na correção cirúrgica das grandes hérnias incisionais, independente da técnica escolhida, na maioria das vezes, o uso de uma prótese é imprescindível. A preferência é pelas próteses de polipropileno.

OBJETIVOS:: Comparar a técnicas onlay e Rives-Stoppa na correção de hérnias incisionais, os seus resultados imediatos, as complicações, as vantagens e desvantagens.

MÉTODOS:: Foram analisados dois grupos de portadores de hérnias incisionais, submetidos à técnica onlay (19 pacientes) e técnica Rives-Stoppa (17 pacientes), utilizando prótese de polipropileno. As variáveis gerais epidemiológicas, variáveis de dados perioperatórios e complicações pós-operatórias foram analisados.

RESULTADOS:: O perfil epidemiológico dos pacientes foi semelhante entre os grupos, a maioria eram mulheres (58.4%), com média de idade de 65.5 anos e com índice de massa corpórea (IMC) médio prévio de 41,5kg/m². A técnica de Rives-Stoppa foi utilizada na maioria dos pacientes (52.7%). Pacientes submetidos a técnica onlay apresentaram maior tempo de uso de dreno abdominal e maior tempo de internação hospitalar, além de maior incidência de seromas e infecção de ferida operatória.

CONCLUSÕES:: A técnica de herniorrafia incisional com colocação de tela de polipropileno pré-peritoneal, pela técnica de Rives-Stoppa apresentou-se superior à técnica onlay, devido menor taxa de uso de drenos, menor taxa de tempo de internação hospitalar, bem como menor taxa de complicações pós-operatórias.

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Conflict of interest statement

Conflict of interests: None

References

    1. Brosi P, Glauser PM, Speich B, Käser SA, Maurer CA. Prophylactic intraperitoneal onlay mesh reinforcement reduces the risk of incisional hernia, two-year results of a randomized clinical trial. World J Surg. 2018;42(6):1687–1694. doi: 10.1007/s00268-017-4363-2. - DOI - PubMed
    1. Carbonell AM., II . In: Hernia surgery. Novitsky YW, editor. Switzerland: Springer International Publishing; 2016. Rives-Stoppa retromuscular repair; pp. 107–115. - DOI
    1. Demetrashvili Z, Pipia I, Loladze D, Metreveli T, Ekaladze E, Kenchadze G, et al. Open retromuscular mesh repair versus onlay technique of incisional hernia: a randomized controlled trial. Int J Surg. 2017;37:65–70. doi: 10.1016/j.ijsu.2016.12.008. - DOI - PubMed
    1. Herbert GS, Tausch TJ, Carter PL. Prophylactic mesh to prevent incisional hernia: a note of caution. Am J Surg. 2009;197(5):595–598. doi: 10.1016/j.amjsurg.2009.01.002. discussion 598. - DOI - PubMed
    1. Holihan JL, Nguyen DH, Nguyen MT, Mo J, Kao LS, Liang MK. Mesh location in open ventral hernia repair: a systematic review and network meta-analysis. World J Surg. 2016;40(1):89–99. doi: 10.1007/s00268-015-3252-9. - DOI - PubMed