O39 ASSOCIATION OF DIFFERENT MESH AND MESH FIXATION COMBINATIONS WITH REOPERATION RISK AFTER LAPAROSCOPIC GROIN HERNIA SURGERY. A SWEDISH HERNIA REGISTRY STUDY OF 25,190 TEP AND TAPP REPAIRS

Abstract Aim The HerniaSurge guidelines concerning mesh and fixation options in laparoscopic totally extraperitoneal (TEP) transabdominal preperitoneal (TAPP) groin hernia repair are based on studies focusing either or fixation. We hypothesized that the value of such recommendations is limited by lacking knowledge how interact. present registry-based nationwide cohort study compared different mesh/fixation combinations regarding relative risks for reoperation after TEP TAPP. Material Methods All TAPP with standard polypropylene (StdPPM) lightweight (LWM) flat meshes, combined tacks, fibrin glue, no fixation, registered Swedish Hernia Registry 2005-2017 were included. Endpoint was due to recurrence as December 31, 2018. Multivariable Cox regression rendered risk differences between exposures, expressed hazard ratios (HR) 95% confidence intervals (CI). Results Of 25 190 repairs, 924 (3.7%) later reoperated recurrence. lowest, mutually equivalent, associated StdPPM without (HR 1), metal tacks 0.8, CI 0.4-1.4), glue 1.1, 0.7-1.6), LWM 1.2, 0.97-1.6). correlated otherwise increased risk, whether 2.0, 1.6-2.6), affixed 1.7, 1.1-2.7), absorbable 2.4, 1.8-3.1). Conclusions With StdPPM, seems not improve outcomes, despite being costlier. Thus, this category, we recommend non-fixation. LWM, which only alternative par non-affixed StdPPM.