Background
Although meshplasty has been established as the gold standard for ventral hernia
repair, there is debate on the mesh-placement site. This study tried to compare
onlay mesh placement with sublay meshplasty in terms of outcome.
Patients and methods
This is a prospective cross-armed study including 65 patients suffering from ventral
hernias who were electively admitted to Sohag University Hospital between
October 2013 and November 2014. Patients were randomly allocated to two
groups: group A included 32 patients who underwent onlay meshplasty and
group B included 33 patients who underwent sublay meshplasty. Patients were
evaluated with respect to the outcome of both techniques and statistically analyzed
after 2 years of follow-up.
Results
Regarding the operative and postoperative outcomes, the operative time was
longer in group B, which was highly significant (P≤0.001). Postoperative wound
pain was less in group B, which was significant (P=0.018). Regarding early
postoperative complications, postoperative superficial infection (P=0.050) and
hematoma formation (P=0.033) were significantly less in group B. Seroma
formation was also significantly less in group B (P=0.050). The mean duration
of postoperative hospital stay was shorter in group B and this was highly significant
(P<0.001). During follow-up, recurrence was seen in group A, which was
statistically significant (P=0.015).
Conclusion
Sublay meshplasty, when feasible, is superior to onlay mesh placement for open
ventral hernia repair.