C D Brandi1,2, S Roche3,4, S Bertone3,4, M E Fratantoni3,4. 1. Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Claudio.brandi@hospitalitaliano.org.ar. 2. , Perón 4190 (C1199ABB), Buenos Aires, Argentina. Claudio.brandi@hospitalitaliano.org.ar. 3. Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 4. , Perón 4190 (C1199ABB), Buenos Aires, Argentina.
Abstract
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.
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.
Authors: Jacobus W A Burger; Roland W Luijendijk; Wim C J Hop; Jens A Halm; Emiel G G Verdaasdonk; Johannes Jeekel Journal: Ann Surg Date: 2004-10 Impact factor: 12.969