LONG-TERM RESULTS OF USING TITANIUM THREAD IMPLANTS IN THE TREATMENT OF ANTERIOR ABDOMINAL WALL HERNIAS

Abstract: the purpose of this work was to study the long-term results of treatment of anterior abdominal wall hernias with the use of mesh implants made of titanium thread.

Material and methods: In this study, a comparative assessment of the long-term results of treatment of 118 patients with umbilical and inguinal hernias was performed. In 62 patients of the main group, a mesh implant made of titanium thread was used, and 56 patients of the comparison group were operated with a polypropylene mesh implant. In the main group, 14.5% of patients were operated from laparoscopic access,  and 9% in the comparison group. The quality of life assessment was performed in 37 (60%) patients from the main group and in 31 (55%) patients from the comparison group.

Results: the Median duration of temporary disability after discharge was 7 days and did not differ significantly  in both groups. 3 months after the operation, the average area of titanium thread implants decreased by 1.8-2.3%, depending on the type of operation. There were no differences in the quality of life between patients of both groups within the period from 6 months to 2 years from the moment of surgery. 2 years after inguinal hernioplasty, no more than 4.8% of patients experienced discomfort at the site of surgery.

Conclusion: the analysis of long-term results of treatment of anterior abdominal wall hernias using a mesh implant made of titanium thread showed no significant differences in the terms of temporary disability after discharge, the level of quality of life and the frequency of implant-associated complications in comparison with the use of a polypropylene implant. The degree of shrinkage of titanium thread mesh implants within 3 months  after surgery is minimal.

1. Bona S., Rosati R., Opocher E., Fiore B., Montorsi M. Pain and quality of life after inguinal hernia surgery: a multicenter randomized controlled trial comparing lightweight vs heavyweight mesh (Supermesh Study). Updates Surg., 2018, Mar,70(1), рр.77-83. doi: 10.1007/s13304-017-0483-3

2. Rutegård M., Gümüsçü R., Stylianidis G., Nordin P., Nilsson E., Haapamäki M.M. Chronic pain, discomfort, quality of life and impact on sex life after open inguinal hernia mesh repair: an expertise-based randomized clinical trial comparing lightweight and heavyweight mesh. Hernia, 201, 3 22(3), рр. 411‐418. doi:10.1007/s10029-018-1734-z

3. Arnold M.R., Coakley K.M., Fromke E.J., Groene S.A., Prasad T., Colavita P.D., Augenstein V.A., Kercher K.W., Heniford B.T. Long-term assessment of surgical and quality-of-life outcomes between lightweight and standard (heavyweight) three-dimensional contoured mesh in laparoscopic inguinal hernia repair. Surgery, 2019, № 165(4), рр. 820‐824. doi:10.1016/j.surg.2018.10.016

4. Georgiou E., Schoina E., Markantonis S.L., Karalis V., Athanasopoulos P.G., Chrysoheris P., Antonakopoulos F., Konstantinidis K. Laparoscopic total extraperitoneal inguinal hernia repair: Retrospective study on prosthetic materials, postoperative management, and quality of life. Medicine (Baltimore), 2018;97(52), e13974. doi:10.1097/MD.0000000000013974

5. Demiray O., Gonullu D., Lari Gedik M., Akyildiz Igdem A., Nihat Koksoy F. Effects of suture tecnique on mesh shrinkage. Asian J Surg., 2019, Jan;42(1), рр. 224-227. doi: 10.1016/j.asjsur.2018.02.002

6. Harsløf S., Zinther N., Harsløf T., Danielsen C., Wara P., Friis-Andersen H. Mesh shrinkage depends on mesh properties and anchoring device: an experimental long-term study in sheep. Hernia, 2017, Feb;21(1), рр. 107-113. doi: 10.1007/s10029-016-1528-0

7. Klinge U., Weyhe D. Hernia surgery: minimization of complications by selection of the «correct mesh». Chirurg., 2014, Feb., Vol. 85(2), рр. 105–111.

8. Sarbaeva N.N., Ponomareva Y.V., Milyakova M.N., Gribkova O.V. Sources of reactive oxygen and nitrogen species in tissue microenvironment of hernioplasty materials. Bulletin of Experimental Biology and Medicine, 2016, Vol. 161(5), рр. 711-714. (In Russ.)

9. Chernov A.V., Ir’yanov YU.M., Radchenko S.A., Chernov V.F., Ir’yanova T.Yu. Issledovanie osobennostej integracii razlichnyh biomaterialov v myagkih i kostnoj tkanyah organizma. Genij ortopedii, 2012, № 1, рр. 97-101. (In Russ.)

10. Parshikov V.V., Samsonov A.V., Romanov R.V., Gradusov V.P., Samsonov A.A., Khodak V.A., Petrov V.V., Tsybusov S.N., Baburin A.B., Kihlyarov P.V., Kazantsev A.A. The first experience of tension-free abdominal wall repair with titan mesh. Meditsinskiy al’manakh, 2011, № 1(20), рр. 107–110. (In Russ.)

11. Novik A.A., Ionova T.I. Guide to quality of life research in medicine. 2nd ed. Еd. Yu.L. Shevchenko, М.: OLMAPRESS, 2007, 313 p. (In Russ.)