P-060 PREFORMED PATCH VS. FLAT PREPERITONEAL MESH FOR PRIMARY AND INCISIONAL HERNIA: A PROPENSITY-SCORE MATCHED ANALYSIS

Abstract

Abstract Aim The MORPHEUS trial (Ponten et al. [2018]) reported better outcomes with a flat preperitoneal polypropylene mesh compared with a preformed patch for primary midline hernia repair. The aim was to evaluate our results with these meshes and to explore the recurrence factors. Material & Methods Observational retrospective study of patients undergoing hernia repair in a tertiary referral center. The preformed patch (PP) was used since April 2013, and the flat preperitoneal mesh (FPM) since March 2016. Recruitment finished in December 2021. A 3:1 Propensity-Score matching was performed to select cases for analysis. Results A total of 156 patients were analysed, 117 with PP and 39 with FPM. There were no differences in baseline characteristics, patients’ comorbidities, rates of midline (96.6% vs. 71.4%) or lateral hernias (3.4% vs. 28.6%) or in the proportion of primary (70.9% vs. 69.2%) and incisional hernias (29.1% vs. 30.8%) in PP and FPM groups, respectively. The median hernia defect was 2.5 cm (IQR: 2–3.22). There was a higher rate of defect closure in FPM (100%; 39/39) compared with PP group (12.8%; 15/117). The recurrence rate was higher in the PP group, with 16.2% (19/117), compared to 2.6% (1/39) in the FPM group (p: 0.027) with a median follow-up of 33.6 months (IQR: 14.2–48.7). In logistic regression, there were no statistically significant differences between meshes (OR: 0.136 [CI95%: 0.018-1.050]), while BMI was a risk factor for recurrence and the defect closure was a protective factor. Conclusion Mesh choice did not influence hernia recurrence.