Detection of peritoneal adhesions using ultrasound examination for the evaluation of an innovative intraperitoneal mesh.

BACKGROUND: In this multicenter study, we evaluated the efficiency of a specific ultrasound examination in detecting postoperative bowel adhesions and assessed the adhesion rate associated with the intraperitoneal use of Parietex composite mesh (polyester mesh covered on the visceral side by a hydrophilic resorbable film).

METHODS: Eighty patients (36 male, 44 female; average age, 58.2 years [ranges 30-80]) were included in a study carried out at eight centers. The main inclusion criterion was the surgical treatment of incisional and umbilical hernias using an intraperitoneal mesh. The results of a preoperative ultrasound examination were compared to a macroscopic perioperative exploration. In addition, in 76 of the 80 patients, a postoperative ultrasound examination was repeated at 2 and 12 months.

RESULTS: The ultrasound findings for peritoneal adhesion detection were as follows: sensitivity, 77%; specificity, 74%; positive predictive value, 65%; negative predictive value, 84%; accuracy, 75%. Postoperative adhesions after 1 year were detected in 14% of patients.

CONCLUSIONS: Although these patients had undergone repeated surgery and treated to be (obese) body mass index (mean, 28), the ultrasound exam had a high accuracy rate; when it was negative, there were no adhesions in 84% of cases. The use of a hydrophilic composite mesh is associated with a low rate of adhesions (14%).