Polyester vs polypropylene, do mesh materials matter? A meta-analysis and systematic review

Figures & data

Figure 1 Recurrence rate according to material.

Figure 2 Recurrence according to mesh weight.

Figure 3 Recurrence rate according to material and mesh weight.

Table 1 PET and PP recurrence rate. Study arms with less than N=5 papers were excluded from subgroup analysis

	PET		PP		PET+PP
	Recurrence rate		Recurrence rate		Overall recurrence rate
	N	% [95% CI]	N	% [95% CI]	N	% [95% CI]
Ventral overall	37	4.8 [3.5–6.5]	72	4.7 [3.7–6.0]	109	4.7 [3.9–5.7]
Laparoscopic	14	3.5 [2.0–6.0]	12	3.0 [1.6–5.7]	26	3.3 [2.2–5.0]
Open	21	5.7 [3.9–8.3]	59	4.9 [3.9–5.7]	80	5.2 [4.2–6.4]
Lightweight (LW)	17	5.6 [3.7–8.5]	18	3.9 [2.4–6.4]	35	4.8 [3.5–6.7]
Laparoscopic LW	0	–	4	–	4	–
Open LW	17	5.6 [3.7–8.6]	14	4.6 [2.6–7.8]	31	5.2 [3.7–7.3]
Heavyweight (HW)	20	4.0 [2.6–6.2]	32	6.3 [4.5–8.8]	52	5.3 [4.1–7.0]
Laparoscopic HW	14	3.5 [2.0–6.1]	4	–	18	4.0 [2.5–6.5]
Open HW	4	–	27	6.0 [4.1–8.6]	31	6.0 [4.3–8.4]

Abbreviations: LW, Lightweight; HW, Heavyweight; PET, Polyester; PP, Polypropylene.

Figure 4 Infection rate according to the surgical technique.

Table 2 PET and PP infection rates. Subgroups with less than N=5 papers were excluded from analysis

	PET		PP		PET+PP
	Infection rate		Infection rate		Overall infection rate
	N	% [95% CI]	N	% [95% CI]	N	% [95% CI]
Ventral overall	30	3.5 [2.5–4.9]	60	5.0 [3.9–6.3]	90	4.4 [3.6–5.4]
Laparoscopic	11	1.0 [0.5–2.2]	10	2.2 [1.1–4.4]	21	1.6 [0.9–2.6]
Open	18	4.8 [3.3–6.7]	49	5.5 [4.3–6.9]	67	5.2 [4.3–6.3]
Lightweight (LW)	14	4.9 [3.2–7.5]	15	4.9 [2.9–7.9]	29	4.8 [3.4–6.7]
Laparoscopic LW	0	–	2	–	2	–
Open LW	14	5.1 [3.5–7.2]	13	5.4 [3.2–9.0]	27	5.1 [3.6–7.1]
Heavyweight (HW)	16	2.2 [1.3–3.7]	26	6.5 [4.7–9.0]	42	4.6 [3.4–6.2]
Laparoscopic HW	11	1.1 [0.5–2.1]	4	–	15	1.3 [0.7–2.6]
Open HW	4	–	21	6.5 [4.4–9.4]	25	6.0 [4.3–8.4]

Abbreviations: LW, Lightweight; HW, Heavyweight; PET, Polyester; PP, Polypropylene.

Table S1 Full list of study data sets

First author	Year	Material	Mesh weight	Surgical approach	Number of patients	Mean follow-up (months)	Number of recurrences	Number of mesh-related recurrences	Number of infections
Adloff M	1987	PET	LIGHT	OPEN	130	96	6	6	7
Ahmad M	2003	PP	HEAVY	OPEN	27	26	0	0	1
Alkhoury F	2011	PP	HEAVY	LAP	141	40	7	–	4
Ammaturo C	2004	PET	HEAVY	–	26	15	1	–	–
Ammaturo C	2010	PET	HEAVY	OPEN	103	42	6	1	4
Armananzas L	2014	PP	HEAVY	LAP	53	12	2	–	0
Arnaud J	2003	PET	HEAVY	LAP	51	12	1	–	–
Arroyo S A	2002	PP	–	OPEN	213	64	2	–	3
Balique	2005	PET	HEAVY	OPEN	51	48	11	1	4
Bansal V	2011	PP	–	LAP	35	16.3	0	0	0
Basoglu	2004	PET	LIGHT	OPEN	61	52.8	6	–	6
Becouarn	1996	PET	LIGHT	OPEN	160	36	7	0	4
Bensaadi H	2014	PP	LIGHT	OPEN	41	36	6	–	2
Berrevoet F	2010	PP	–	OPEN	205	36	7	–	12
Berrevoet F	2011	PP	LIGHT	OPEN	56	48.8	2	–	0
Berrevoet F	2009	PP	LIGHT	LAP	114	27	4	–	–
Bessa S	2013	PP	HEAVY	OPEN	80	49.9	1	–	–
Bhanot P	2013	PP	LIGHT	LAP	100	50	0	0	0
Bingener J	2004	PP	HEAVY	LAP	30	14	1	–	0
Bracci F	2008	PP	–	OPEN	26	24	0	0	0
Briennon	2011	PET	HEAVY	OPEN	280	12–108	9	0	12
Champetier	1978	PET	LIGHT	OPEN	51	21	1	0	–
Champetier	1990	PET	LIGHT	OPEN	54	42	5	–	4
Chelala E	2010	PET	HEAVY	LAP	608	52	25	9	0
Chowbey P	2000	PP	–	LAP	202	34.8	2	–	5
Colon MJ	2011	PET	HEAVY	LAP	50	12	1	–	0
Conze	2005	PET	LIGHT	OPEN	34	24	5	–	3
de Ruiter P	2005	PP	–	OPEN	46	60	7	–	3
del Pozo M	2003	PP	HEAVY	OPEN	32	23.6	0	0	0
Eriksen	2011	PET	HEAVY	LAP	19	16	0	0	1
Fei Y	2012	PP	LIGHT	OPEN	26	14.5	0	0	1
Gherardi	2013	PET	HEAVY	LAP	118	66	4	0	0
Ghnnam WM	2009	PP	HEAVY	OPEN	29	30	0	0	2
Gleysteen J	2009	PP	HEAVY	OPEN	75	66	15	–	9
Gomez R	2001	PP	HEAVY	OPEN	37	42	6	6	–
Gronnier C	2012	PP	HEAVY	OPEN	121	24.6	17	–	12
Gutierrez de la P C	2003	PP	HEAVY	OPEN	50	36	0	0	1
Guzman-Valdivia G	2008	PP	LIGHT	OPEN	25	12	2	–	2
Guzman-Valdivia G	2001	PP	–	OPEN	50	24	0	0	–
Hadi H	2006	PP	LIGHT	OPEN	51	15	1	–	2
Hamy	2003	PET	LIGHT	OPEN	350	97.2	11	11	14
Han J	2007	PP	HEAVY	OPEN	48	32	2	–	–
Hasbahceci M	2014	PP	–	OPEN	25	42.6	1	–	0
Iversen E	2010	PP	LIGHT	OPEN	152	15.6	4	–	4
Janes A	2004	PP	LIGHT	OPEN	27	24	1	–	0
Johanet	2005	PET	HEAVY	OPEN	122	12	3	–	2
Korenkov M	2002	PP	HEAVY	OPEN	39	16	3	–	4
Kulacoglu H	2012	PP	–	OPEN	100	12	0	0	3
Lahon	2009	PET	HEAVY	LAP	71	13	13	0	1
Lepère M	2008	PET	HEAVY	LAP	29	12	1	–	–
Lermite E	2004	PET	HEAVY	LAP	26	33	0	0	1
Lewis R	1984	PP	HEAVY	OPEN	50	30	3	–	2
Liu F	2011	PP	LIGHT	OPEN	36	28	0	0	4
Luijendijk R	2000	PP	HEAVY	OPEN	84	26	19	5	–
Machairas	2004	PET	LIGHT	OPEN	43	54.4	4	3	3
Mahmoud Uslu H	2006	PP	HEAVY	OPEN	291	55	6	–	8
Maman D	2012	PP	–	OPEN	40	40	0	0	–
Martin-Duce A	2001	PP	HEAVY	OPEN	284	72	4	–	11
Mathonnet	1998	PET	LIGHT	OPEN	99	12	4	–	6
McCarthy JD	1981	PP	HEAVY	OPEN	25	48	2	–	1
Mehrabi M	2010	PET	LIGHT	OPEN	176	96	2	2	3
Moreno-Egea	2004	PET	HEAVY	LAP	86	42	3	3	0
Moreno-Egea	2004	PET	HEAVY	LAP	127	64	5	–	1
Moreno-Egea	2008	PET	HEAVY	LAP	55	18	1	1	0
Moreno-Egea	2013	PET	HEAVY	LAP	51	24	0	0	–
Moreno-Egea A	2010	PP	LIGHT	OPEN	50	48	0	0	3
Murtaza, B	2009	PP	–	OPEN	33	15.78	0	0	1
Nardi MJ	2012	PET	HEAVY	LAP	87	12	2	–	1
Notash	2007	PET	LIGHT	OPEN	51	67.6	4	–	–
Novitsky Y	2006	PP	–	OPEN	128	28.1	4	0	4
Olmi S	2006	PET	HEAVY	LAP	178	29	4	–	1
Paajanen H	2004	PP	HEAVY	OPEN	84	36	4	–	–
Petersen S	2004	PP	HEAVY	OPEN	130	20	5	–	6
Piardi T	2010	PP	–	OPEN	25	75	1	–	–
Poelman, M	2010	PP	HEAVY	–	101	64	16	–	22
Poghosyan T	2012	PET	LIGHT	OPEN	262	58	8	8	2
Prasad P	2011	PP	–	LAP	68	22.7	2	–	0
Qadri S	2010	PP	–	OPEN	40	26	1	–	6
Quarmby C	2001	PP	HEAVY	OPEN	32	35.4	1	–	9
Rives	1985	PET	LIGHT	OPEN	218	36	7	0	18
Rosen MR	2014	PET	LIGHT	OPEN	36	13	8	8	–
Rosen MJ	2009	PET	HEAVY	–	109	14	3	–	5
Rosenberg J	2008	PP	LIGHT	LAP	49	17	0	0	1
Sauerland S	2005	PP	HEAVY	OPEN	74	60	4	–	2
Schmidbauer S	2005	PP	HEAVY	OPEN	69	92	2	–	2
Shukla V	2005	PP	–	OPEN	55	37	0	0	2
Steele S	2003	PP	–	OPEN	58	50.6	15	–	2
Stoikes N	2013	PP	–	OPEN	50	19.5	0	0	3
Sugerman H	1996	PP	HEAVY	OPEN	98	20	4	–	17
Trivellini G	2001	PP	–	OPEN	270	32.5	1	–	1
van’t R	2002	PP	HEAVY	LAP	25	16	4	–	1
Veyrie N	2013	PET	LIGHT	OPEN	61	47	3	–	0
Vijayasekar C	2008	PP	–	OPEN	42	31	4	–	1
Vychnevskaia K	2010	PP	LIGHT	OPEN	101	28.5	2	–	–
Welty G	2001	PP	HEAVY	OPEN	115	24	11	–	–
Wheeler	2009	PET	LIGHT	OPEN	90	46	6	–	10
Yildirim M	2010	PP	HEAVY	OPEN	25	28	0	0	3

Abbreviations: PET, Polyester; PP, Polypropylene; LAP, Laparoscopic.