[Randomised study of the use resorbable mesh for the prevention of evisceration in colorectal surgery]. / Estudio aleatorizado sobre la utilización de mallas reabsorbibles para la prevención de la evisceración en la cirugía colorrectal.

ABSTRACT

INTRODUCTION: Evisceration is a complication that causes high morbidity and mortality, and its incidence in colorectal surgery varies between 2% and 3.5%. We evaluated the results of the use of resorbable meshes in the primary closure of laparotomies, with the purpose of preventing evisceration in colorectal surgery. PATIENTS AND METHOD: One hundred and forty three patients were included (63 females/80 males) and divided in two groups simple closed laparotomy (Group A) (72 patients) and closed with polyglycolic mesh (Group B) (73 patients), mean age 64 years (range 24-93). We evaluated general and previous clinical data, as well as evisceration, infection, seroma and other acute complications after the surgery. RESULTS: There were no differences between group distribution by general performances, associated pathology, clinical state and primary diagnosis. Most of Group B had programmed surgery (p = 0.045); mesh was used in 4 of 5 patients with faecal peritonitis, as expected drainage requirements were significant in Group B was needed significantly needed use drainages (Group A, 2.8%; Group B, 97.2%; p < 0.0005) and subsequent FNA after their withdrawal (p < 0.05). Overall incidence of evisceration was 3.5%, with Group A 5.6% and Group B 1.4%, with no significant differences. There were no differences in wounded infection. CONCLUSIONS: This study has not been able to demonstrate that primary closure with mesh in these patients prevents evisceration, due to small sample size, and having a high incidence of seromas. Until further studies are carried out, its use should be reserved for selected cases, as it can be used in the presence of pus or faeces.