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Hernia. 2017 Feb;21(1):101-106. doi: 10.1007/s10029-016-1530-6. Epub 2016 Aug 13.

No enterocutaneous fistula development in a cohort of 695 patients after incisional hernia repair using intraperitoneal uncoated polyproylene mesh.

Author information

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.

KEYWORDS:

Enterocutaneous fistula; Incisional hernia; Intraperitoneal; Mesh; Polypropylene

PMID:
27522361
DOI:
10.1007/s10029-016-1530-6
[Indexed for MEDLINE]

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