Weighing the benefits: Exploring the differential effects of light-weight and heavy-weight polypropylene meshes in inguinal hernia repair in a retrospective cohort study

Am J Surg. 2024 Dec:238:115950. doi: 10.1016/j.amjsurg.2024.115950. Epub 2024 Sep 7.

Abstract

Background: Inguinal hernia repair is a common surgical procedure, with more than 20 million cases yearly. Choice between mesh types varies in clinical practice. To compare light-weight polypropylene (LW-PP, 34-36 g/m2) and heavy-weight polypropylene (HW-PP, 95 ​g/m2) meshes.

Methods: Data from patients who underwent open inguinal hernia repair between 2020 and 2022. Selection criteria ensured homogeneity. Endpoints were to assess the impact of different mesh weights on overall health-related quality of life (HRQoL), using Short Form 36 (SF-36), and to monitor postoperative complications.

Results: Two hundred patients were included in both groups. Lateral and direct hernias occurred in 60.5 ​% and 39.5 ​%. According to EHS, 31.5 ​%, 22.3 ​% and 46.2 ​% were classified as size 1, 2, 3. Follow-up showed similar HRQoL at 30-days, with a favorable trend towards LW-PP mesh offering fewer limitations, better comfort, and improved general health after 12-months. No difference in postoperative paresthesia, wound hematoma, and interference with daily activities.

Conclusion: 1-year after surgery HRQoL evaluation highlights the non-inferiority of LW-PP. Mesh selection should be tailored, aiming at improving outcomes and postoperative comfort.

Keywords: Heavyweight; Inguinal hernia repair; Lightweight; Polypropylene meshes; Quality of life.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Hernia, Inguinal* / surgery
  • Herniorrhaphy* / adverse effects
  • Herniorrhaphy* / instrumentation
  • Herniorrhaphy* / methods
  • Humans
  • Male
  • Middle Aged
  • Polypropylenes*
  • Postoperative Complications / epidemiology
  • Quality of Life*
  • Retrospective Studies
  • Surgical Mesh*

Substances

  • Polypropylenes