Ventral hernia repair and mesh use in females of childbearing age
Background A substantial knowledge gap exists in understanding sex as a biological variable for abdominal wall hernia repair, which also extends to hernia repair practices in females of childbearing age. We sought to determine the incidence of mesh repairs in females of childbearing age and to chara...
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| Veröffentlicht in: | Surgical endoscopy 2023-04, Vol.37 (4), p.3084-3089 |
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| creator | Shen, Mary R. Howard, Ryan Ehlers, Anne P. Delaney, Lia Solano, Quintin Englesbe, Michael Dimick, Justin Telem, Dana |
| description | Background
A substantial knowledge gap exists in understanding sex as a biological variable for abdominal wall hernia repair, which also extends to hernia repair practices in females of childbearing age. We sought to determine the incidence of mesh repairs in females of childbearing age and to characterize factors associated with mesh use.
Methods
Using a statewide hernia-specific data registry, we conducted a retrospective study identifying females of childbearing age, defined as 18–44 per CDC guidelines, who underwent clean ventral hernia repair between January 2020 and Dec 2021. The primary outcome was mesh use. Multivariable logistic regression was used to examine factors associated with mesh use. To further delineate whether childbearing status may affect decision to use mesh, we also examined mesh practice stratified by age, comparing women 18 to 44 to those 45 and older.
Results
Eight hundred and thirty-six females of childbearing age underwent ventral hernia repair with a mean age of 34.8 (6.2) years. Mesh was used in 547 (65.4%) patients. Mesh use was significantly associated with minimally invasive approach [aOR 29.46 (95% CI 16.30–53.25)], greater hernia width [aOR 1.50 (95% CI 1.20–1.88)], and greater BMI [aOR 1.05 (95% CI 1.03–1.08)]. Age was not significantly associated with mesh use [aOR 1.02 (95% CI 0.99–1.05)]. Compared to 1,461 female patients older than 44 years old, there was no significant association between childbearing age and mesh use [aOR 0.77 (95% CI 0.57–1.04)].
Conclusions
Most females of childbearing age had mesh placed during ventral and incisional hernia repair, which was largely associated with hernia size, BMI, and a minimally invasive surgical approach. Neither chronologic patient age nor being of childbearing age were associated with mesh use. Insofar as existing evidence suggests that childbearing status is an important factor in deciding whether to use mesh, these findings suggest that real-world practice may not reflect that evidence. |
| doi_str_mv | 10.1007/s00464-022-09429-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2699707779</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2797453357</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-1e7bb01ac67c449d9dd9ba73a3057dde6b3aa7dc087361b03e2cea98fec2ce7c3</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMoWqt_wIMEvHhZzdfuNEcpfoHgRb2GbDLbbtmPmnSh_ntTWxU8eJo5PO87w0PIGWdXnDG4joypQmVMiIxpJXS23iMjrqTIhOCTfTJiWrJMgFZH5DjGBUu85vkhOZK5FiAVjMjNG3arYBs6x9DVlgZc2jpQ23naYpzTISKtO1phaxuMtK-om9eNL9GGuptRO8MTclDZJuLpbo7J693ty_Qhe3q-f5zePGVOQr7KOEJZMm5dAU4p7bX3urQgrWQ5eI9FKa0F79gEZMFLJlE4tHpSoUsLODkml9veZejfB4wr09bRYdPYDvshGlFoDQwAdEIv_qCLfghd-s4kG6ByKXNIlNhSLvQxBqzMMtStDR-GM7MRbLaCTRJsvgSbdQqd76qHskX_E_k2mgC5BeJyYwjD7-1_aj8BhbeGMg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2797453357</pqid></control><display><type>article</type><title>Ventral hernia repair and mesh use in females of childbearing age</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Shen, Mary R. ; Howard, Ryan ; Ehlers, Anne P. ; Delaney, Lia ; Solano, Quintin ; Englesbe, Michael ; Dimick, Justin ; Telem, Dana</creator><creatorcontrib>Shen, Mary R. ; Howard, Ryan ; Ehlers, Anne P. ; Delaney, Lia ; Solano, Quintin ; Englesbe, Michael ; Dimick, Justin ; Telem, Dana</creatorcontrib><description>Background
A substantial knowledge gap exists in understanding sex as a biological variable for abdominal wall hernia repair, which also extends to hernia repair practices in females of childbearing age. We sought to determine the incidence of mesh repairs in females of childbearing age and to characterize factors associated with mesh use.
Methods
Using a statewide hernia-specific data registry, we conducted a retrospective study identifying females of childbearing age, defined as 18–44 per CDC guidelines, who underwent clean ventral hernia repair between January 2020 and Dec 2021. The primary outcome was mesh use. Multivariable logistic regression was used to examine factors associated with mesh use. To further delineate whether childbearing status may affect decision to use mesh, we also examined mesh practice stratified by age, comparing women 18 to 44 to those 45 and older.
Results
Eight hundred and thirty-six females of childbearing age underwent ventral hernia repair with a mean age of 34.8 (6.2) years. Mesh was used in 547 (65.4%) patients. Mesh use was significantly associated with minimally invasive approach [aOR 29.46 (95% CI 16.30–53.25)], greater hernia width [aOR 1.50 (95% CI 1.20–1.88)], and greater BMI [aOR 1.05 (95% CI 1.03–1.08)]. Age was not significantly associated with mesh use [aOR 1.02 (95% CI 0.99–1.05)]. Compared to 1,461 female patients older than 44 years old, there was no significant association between childbearing age and mesh use [aOR 0.77 (95% CI 0.57–1.04)].
Conclusions
Most females of childbearing age had mesh placed during ventral and incisional hernia repair, which was largely associated with hernia size, BMI, and a minimally invasive surgical approach. Neither chronologic patient age nor being of childbearing age were associated with mesh use. Insofar as existing evidence suggests that childbearing status is an important factor in deciding whether to use mesh, these findings suggest that real-world practice may not reflect that evidence.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-022-09429-x</identifier><identifier>PMID: 35927347</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>2022 SAGES Oral ; Abdominal Surgery ; Adult ; Age ; Body mass index ; Child ; Disease control ; Endoscopy ; Female ; Females ; Gastroenterology ; Gynecology ; Hepatology ; Hernia, Ventral - etiology ; Hernia, Ventral - surgery ; Hernias ; Herniorrhaphy - adverse effects ; Humans ; Incidence ; Incisional Hernia - surgery ; Laparoscopy ; Medicine ; Medicine & Public Health ; Patients ; Pregnancy ; Proctology ; Recurrence ; Regression analysis ; Retrospective Studies ; Surgery ; Surgical Mesh ; Variables ; Womens health</subject><ispartof>Surgical endoscopy, 2023-04, Vol.37 (4), p.3084-3089</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-1e7bb01ac67c449d9dd9ba73a3057dde6b3aa7dc087361b03e2cea98fec2ce7c3</citedby><cites>FETCH-LOGICAL-c375t-1e7bb01ac67c449d9dd9ba73a3057dde6b3aa7dc087361b03e2cea98fec2ce7c3</cites><orcidid>0000-0001-9877-9603</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-022-09429-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-022-09429-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35927347$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shen, Mary R.</creatorcontrib><creatorcontrib>Howard, Ryan</creatorcontrib><creatorcontrib>Ehlers, Anne P.</creatorcontrib><creatorcontrib>Delaney, Lia</creatorcontrib><creatorcontrib>Solano, Quintin</creatorcontrib><creatorcontrib>Englesbe, Michael</creatorcontrib><creatorcontrib>Dimick, Justin</creatorcontrib><creatorcontrib>Telem, Dana</creatorcontrib><title>Ventral hernia repair and mesh use in females of childbearing age</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
A substantial knowledge gap exists in understanding sex as a biological variable for abdominal wall hernia repair, which also extends to hernia repair practices in females of childbearing age. We sought to determine the incidence of mesh repairs in females of childbearing age and to characterize factors associated with mesh use.
Methods
Using a statewide hernia-specific data registry, we conducted a retrospective study identifying females of childbearing age, defined as 18–44 per CDC guidelines, who underwent clean ventral hernia repair between January 2020 and Dec 2021. The primary outcome was mesh use. Multivariable logistic regression was used to examine factors associated with mesh use. To further delineate whether childbearing status may affect decision to use mesh, we also examined mesh practice stratified by age, comparing women 18 to 44 to those 45 and older.
Results
Eight hundred and thirty-six females of childbearing age underwent ventral hernia repair with a mean age of 34.8 (6.2) years. Mesh was used in 547 (65.4%) patients. Mesh use was significantly associated with minimally invasive approach [aOR 29.46 (95% CI 16.30–53.25)], greater hernia width [aOR 1.50 (95% CI 1.20–1.88)], and greater BMI [aOR 1.05 (95% CI 1.03–1.08)]. Age was not significantly associated with mesh use [aOR 1.02 (95% CI 0.99–1.05)]. Compared to 1,461 female patients older than 44 years old, there was no significant association between childbearing age and mesh use [aOR 0.77 (95% CI 0.57–1.04)].
Conclusions
Most females of childbearing age had mesh placed during ventral and incisional hernia repair, which was largely associated with hernia size, BMI, and a minimally invasive surgical approach. Neither chronologic patient age nor being of childbearing age were associated with mesh use. Insofar as existing evidence suggests that childbearing status is an important factor in deciding whether to use mesh, these findings suggest that real-world practice may not reflect that evidence.</description><subject>2022 SAGES Oral</subject><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Age</subject><subject>Body mass index</subject><subject>Child</subject><subject>Disease control</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Females</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hernia, Ventral - etiology</subject><subject>Hernia, Ventral - surgery</subject><subject>Hernias</subject><subject>Herniorrhaphy - adverse effects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Incisional Hernia - surgery</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patients</subject><subject>Pregnancy</subject><subject>Proctology</subject><subject>Recurrence</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Mesh</subject><subject>Variables</subject><subject>Womens health</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1LAzEQhoMoWqt_wIMEvHhZzdfuNEcpfoHgRb2GbDLbbtmPmnSh_ntTWxU8eJo5PO87w0PIGWdXnDG4joypQmVMiIxpJXS23iMjrqTIhOCTfTJiWrJMgFZH5DjGBUu85vkhOZK5FiAVjMjNG3arYBs6x9DVlgZc2jpQ23naYpzTISKtO1phaxuMtK-om9eNL9GGuptRO8MTclDZJuLpbo7J693ty_Qhe3q-f5zePGVOQr7KOEJZMm5dAU4p7bX3urQgrWQ5eI9FKa0F79gEZMFLJlE4tHpSoUsLODkml9veZejfB4wr09bRYdPYDvshGlFoDQwAdEIv_qCLfghd-s4kG6ByKXNIlNhSLvQxBqzMMtStDR-GM7MRbLaCTRJsvgSbdQqd76qHskX_E_k2mgC5BeJyYwjD7-1_aj8BhbeGMg</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Shen, Mary R.</creator><creator>Howard, Ryan</creator><creator>Ehlers, Anne P.</creator><creator>Delaney, Lia</creator><creator>Solano, Quintin</creator><creator>Englesbe, Michael</creator><creator>Dimick, Justin</creator><creator>Telem, Dana</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9877-9603</orcidid></search><sort><creationdate>20230401</creationdate><title>Ventral hernia repair and mesh use in females of childbearing age</title><author>Shen, Mary R. ; Howard, Ryan ; Ehlers, Anne P. ; Delaney, Lia ; Solano, Quintin ; Englesbe, Michael ; Dimick, Justin ; Telem, Dana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-1e7bb01ac67c449d9dd9ba73a3057dde6b3aa7dc087361b03e2cea98fec2ce7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>2022 SAGES Oral</topic><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Age</topic><topic>Body mass index</topic><topic>Child</topic><topic>Disease control</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Females</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hernia, Ventral - etiology</topic><topic>Hernia, Ventral - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - adverse effects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Incisional Hernia - surgery</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patients</topic><topic>Pregnancy</topic><topic>Proctology</topic><topic>Recurrence</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Mesh</topic><topic>Variables</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shen, Mary R.</creatorcontrib><creatorcontrib>Howard, Ryan</creatorcontrib><creatorcontrib>Ehlers, Anne P.</creatorcontrib><creatorcontrib>Delaney, Lia</creatorcontrib><creatorcontrib>Solano, Quintin</creatorcontrib><creatorcontrib>Englesbe, Michael</creatorcontrib><creatorcontrib>Dimick, Justin</creatorcontrib><creatorcontrib>Telem, Dana</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shen, Mary R.</au><au>Howard, Ryan</au><au>Ehlers, Anne P.</au><au>Delaney, Lia</au><au>Solano, Quintin</au><au>Englesbe, Michael</au><au>Dimick, Justin</au><au>Telem, Dana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventral hernia repair and mesh use in females of childbearing age</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>37</volume><issue>4</issue><spage>3084</spage><epage>3089</epage><pages>3084-3089</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
A substantial knowledge gap exists in understanding sex as a biological variable for abdominal wall hernia repair, which also extends to hernia repair practices in females of childbearing age. We sought to determine the incidence of mesh repairs in females of childbearing age and to characterize factors associated with mesh use.
Methods
Using a statewide hernia-specific data registry, we conducted a retrospective study identifying females of childbearing age, defined as 18–44 per CDC guidelines, who underwent clean ventral hernia repair between January 2020 and Dec 2021. The primary outcome was mesh use. Multivariable logistic regression was used to examine factors associated with mesh use. To further delineate whether childbearing status may affect decision to use mesh, we also examined mesh practice stratified by age, comparing women 18 to 44 to those 45 and older.
Results
Eight hundred and thirty-six females of childbearing age underwent ventral hernia repair with a mean age of 34.8 (6.2) years. Mesh was used in 547 (65.4%) patients. Mesh use was significantly associated with minimally invasive approach [aOR 29.46 (95% CI 16.30–53.25)], greater hernia width [aOR 1.50 (95% CI 1.20–1.88)], and greater BMI [aOR 1.05 (95% CI 1.03–1.08)]. Age was not significantly associated with mesh use [aOR 1.02 (95% CI 0.99–1.05)]. Compared to 1,461 female patients older than 44 years old, there was no significant association between childbearing age and mesh use [aOR 0.77 (95% CI 0.57–1.04)].
Conclusions
Most females of childbearing age had mesh placed during ventral and incisional hernia repair, which was largely associated with hernia size, BMI, and a minimally invasive surgical approach. Neither chronologic patient age nor being of childbearing age were associated with mesh use. Insofar as existing evidence suggests that childbearing status is an important factor in deciding whether to use mesh, these findings suggest that real-world practice may not reflect that evidence.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>35927347</pmid><doi>10.1007/s00464-022-09429-x</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-9877-9603</orcidid></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | 2022 SAGES Oral Abdominal Surgery Adult Age Body mass index Child Disease control Endoscopy Female Females Gastroenterology Gynecology Hepatology Hernia, Ventral - etiology Hernia, Ventral - surgery Hernias Herniorrhaphy - adverse effects Humans Incidence Incisional Hernia - surgery Laparoscopy Medicine Medicine & Public Health Patients Pregnancy Proctology Recurrence Regression analysis Retrospective Studies Surgery Surgical Mesh Variables Womens health |
| title | Ventral hernia repair and mesh use in females of childbearing age |
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