Comment on “onlay and sublay (retrorectus) mesh repair for incisional hernia”
Pathum Sookaromdee1, Viroj Wiwanitkit2
1 Private Academic Consultant, Bangkok, Thailand
2 Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India
Correspondence Address:
Pathum Sookaromdee
Private Academic Consultant, 111 Bangkok 112 Bangkok 103300
Thailand
Source of Support: None, Conflict of Interest: None
DOI: 10.4103/fjs.fjs_132_22
Dear Editor,
We would like to share ideas on the report “comparative analysis of onlay (OL) and sublay (SL) (retrorectus) mesh repair for incisional hernia (width ≤10 cm) of the abdominal wall: A single-center experience.[1]” Kumar et al. concluded that “SR seems to be the better technique taking into account the overall morbidity, although the need for multi-centric trials with patient-centered outcomes should be highlighted to settle the debate.[1]” We agree that there might be a difference in the outcome of OL and SL approaches for the management of incisional hernia. The recent publication from meta-analysis showed that OL was associated with significantly poorer outcomes.[2] The current study gives supporting clinical evidence. However, it should recognize the possible confounding factors in this retrospective study. The preoperation criteria for assigning patients for OL and SL approaches might relate to the morbidity outcome. The type of incisional hernia is also associated with the outcome of surgical management.[3] In addition, the patient might have different physiological backgrounds and underlying/concurrent conditions that can affect the outcome. A subgroup analysis based on the different backgrounds of the patient might give a clearer picture for comparing both approaches.
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