Hernia : the journal of hernias and abdominal wall surgery · 2016
No enterocutaneous fistula development in a cohort of 695 patients after incisional hernia repair using intraperitoneal uncoated polyproylene mesh.
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Brandi C D, Roche S, Bertone S, Fratantoni M E
Аннотация
PURPOSE: To determine the incidence of enterocutaneous fistulas (ECFs) developed after elective incisional hernia (IH) repair using intraperitoneal uncoated polypropylene (PPE) mesh.
METHODS: This is a retrospective descriptive study of a prospective cohort of patients undergoing elective IH repair using intraperitoneal uncoated PPE mesh at the Department of General Surgery of a high complexity University Hospital.
RESULTS: Between January 1992 and December 2013, 695 IH repairs were performed using intraperitoneal uncoated PPE mesh. The omentum was placed between the mesh and bowel in 507 patients (73 %). In 188 patients (27 %) it was not possible to place the omentum between the mesh and bowel; therefore, in 69 patients (9.92 %) the PPE mesh was placed over the bowel, whereas in 119 patients (17.12 %) a Vicryl® mesh was placed between the bowel and PPE mesh. Six hundred and seventy-eight (97.5 %) IH repairs were open whereas 17 (2.5 %) were laparoscopic. Postoperative complications consisted of seroma (5.9 %), hematoma (4.3 %), wound infection (4.8 %), and mesh infection (4.0 %). Recurrence of IH occurred in 52 patients (7.4 %) after a mean follow-up of 59 months. Four (0.5 %) patients required additional surgery due to intestinal occlusion. Neither acute nor chronic ECFs were encountered during follow-up in 695 patients.
CONCLUSION: Based on these results, the placement of intraperitoneal uncoated PPE mesh for elective IH repair might be a safe procedure that is not associated with ECF formation.
METHODS: This is a retrospective descriptive study of a prospective cohort of patients undergoing elective IH repair using intraperitoneal uncoated PPE mesh at the Department of General Surgery of a high complexity University Hospital.
RESULTS: Between January 1992 and December 2013, 695 IH repairs were performed using intraperitoneal uncoated PPE mesh. The omentum was placed between the mesh and bowel in 507 patients (73 %). In 188 patients (27 %) it was not possible to place the omentum between the mesh and bowel; therefore, in 69 patients (9.92 %) the PPE mesh was placed over the bowel, whereas in 119 patients (17.12 %) a Vicryl® mesh was placed between the bowel and PPE mesh. Six hundred and seventy-eight (97.5 %) IH repairs were open whereas 17 (2.5 %) were laparoscopic. Postoperative complications consisted of seroma (5.9 %), hematoma (4.3 %), wound infection (4.8 %), and mesh infection (4.0 %). Recurrence of IH occurred in 52 patients (7.4 %) after a mean follow-up of 59 months. Four (0.5 %) patients required additional surgery due to intestinal occlusion. Neither acute nor chronic ECFs were encountered during follow-up in 695 patients.
CONCLUSION: Based on these results, the placement of intraperitoneal uncoated PPE mesh for elective IH repair might be a safe procedure that is not associated with ECF formation.