Recognition and management of Marlex erosion after horizontal gastroplasty for morbid obesity.

Between 1979 and 1982, 162 patients underwent horizontal gastroplasty in which polypropylene mesh (Marlex) was used to support the greater curve channel. There were no deaths and early weight loss was good. The operation was stopped because of late weight gain. Marlex erosion was recognized by endoscopy in 10 (6%) patients between 27 and 60 months after operation. Two other patients with Marlex erosion had the gastroplasty performed elsewhere. The patients' symptoms were abdominal pain, vomiting or weight gain. The Marlex was often difficult to resect because the inflammatory mass was adherent to spleen or pancreas. Reconstruction by Roux-en-Y gastric bypass or vertical banded gastroplasty allowed continued weight loss and gastrogastrostomy, although technically easier, resulted in weight gain. The author concludes that long-term follow-up is necessary after any gastroplasty or gastric bypass procedure especially when foreign material is used to support the stoma.