Evidence map›Paper›PMID 39239718›Full record

Trial reportAnnals of surgery2026

Prophylactic Mesh-related Reoperations and Mesh-related Problems During Subsequent Relaparotomies: Long-term Results From the PRIMA Trial.

Rudolf van den Berg, Louis Matthijs van den Dop, Lucas Timmermans, Michiel van den Berg, Robert E G J M Pierik, Willem A R Zwaans, Daniel Reim, Steven E Buijk, Jerome P van Brussel, Johan F Lange and 2 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Review
  3. Observational
  4. Article
  5. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rudolf van den BergDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.ORCID 0009-0001-8850-6166
Louis Matthijs van den DopDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Lucas TimmermansDepartment of Surgery, Radboud University Hospital, Nijmegen, The Netherlands.
Michiel van den BergDepartment of surgery, Treant Zorggroep, Emmen, The Netherlands.
Robert E G J M PierikDepartment of Surgery, Isala Clinic, Zwolle, The Netherlands.
Willem A R ZwaansSolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Máxima Medisch Centrum, Veldhoven, The Netherlands.
Daniel ReimDepartment of Surgery, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Steven E BuijkDepartment of Surgery, IJsseland Hospital, Capelle aan den Ijssel, The Netherlands.
Jerome P van BrusselDepartment of Vascular Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.
Johan F LangeDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Johannes J JeekelDepartment of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands.
Pieter J TanisDepartment of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate all mesh-related problems during reoperations after mesh reinforcement of the abdominal wall 15 years after the start of the PRIMA trial.

backgroundProphylactic mesh reinforcement during closure of a midline laparotomy has proven to reduce the incidence of incisional hernia, especially in high-risk patients, but long-term mesh-related morbidity is largely unknown.

methodsPatients receiving a prophylactic onlay or retrorectus mesh in the PRIMA trial between 2009 and 2012 were included on an as-treated basis from participating centers that made reoperation notes available. The main outcomes were the incidences of complications requiring mesh explantation, mesh-related ileus, and mesh-related problems during laparotomy for other diagnoses.

resultsOut of 373 patients randomized to prophylactic mesh reinforcement, 242 were included: 127 with onlay and 115 patients with retrorectus mesh. Median follow-up is 27 months (interquartile range: 12-78). Thirty-four patients underwent reoperation for any reason during the entire follow-up, 22 after onlay (17.3%), and 12 after retrorectus mesh (10.4%). The reoperation rate for complications that required mesh explantation was 4/127 (3.1%) after onlay and 0/115 (0%) after retrorectus mesh. Mesh-related ileus occurred in none of the onlay group, and 3/115 (2.6%) in the retrorectus group. During subsequent laparotomies for other primary diagnoses, adhesions to the mesh were noted in 3/10 patients in the onlay group and 1/5 patients in the retrorectus group. Overall, the mesh was removed in 10/127 (7.9%) in the onlay group and 7/115 (6.1%) patients in the retrorectus group.

conclusionsIn high-risk patients receiving a prophylactic mesh during midline laparotomy closure, low incidences of mesh-related complications requiring reoperation and mesh-related problems during unrelated subsequent laparotomies were found, for both the onlay and retrorectus techniques.

Indexed as

Hernia, VentralIncisional HerniaLaparotomyPostoperative ComplicationsSurgical MeshAgedFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedReoperationTime FactorsTreatment Outcomecomplicationsmeshonlayprophylacticreoperationretrorectus

Identifiers

PMID39239718
PMCPMC12978706

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.