Impact of mesh use on morbidity following ventral hernia repair with a simultaneous bowel resection.
Arch Surg
; 145(8): 739-44, 2010 Aug.
Article
en En
| MEDLINE
| ID: mdl-20713925
ABSTRACT
OBJECTIVE:
To evaluate the impact of mesh use on outcomes following ventral hernia repairs and simultaneous bowel resection.DESIGN:
Retrospective review.SETTING:
Teaching academic hospital. PATIENTS We studied 177 patients who underwent a ventral hernia repair with a bowel resection between May 1, 1992, and May 30, 2007. A prosthesis was used in 51 repairs (mesh group), while 126 repairs were primary (mesh-free group). MAIN OUTCOMEMEASURES:
Demographic characteristics, comorbidities, mesh type, bowel resection type (colon vs small bowel), defect size, drain use, and length of hospital stay were compared between groups with Fisher exact test and multivariate analysis.RESULTS:
There were no statistically significant differences between patient characteristics and relevant comorbidities. The incidence of postoperative infection (superficial or deep) was 22% in the mesh group vs 5% in the mesh-free group (P = .001). Other complications (fistula, seroma, hematoma, bowel obstruction) occurred in 24% of patients in the mesh group vs 8% of patients in the mesh-free group (P = .009). Focusing on the patients who developed an infection, prosthetic mesh use was the only significant risk factor on multivariate regression analysis, irrespective of drain use, defect size, and type of bowel resection.CONCLUSIONS:
We recommend caution in using mesh when performing a ventral hernia repair with a simultaneous bowel resection because of significantly increased postoperative infectious complications. Drain use, defect size, and bowel resection type did not influence outcomes.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Mallas Quirúrgicas
/
Hernia Ventral
/
Enfermedades Intestinales
Tipo de estudio:
Observational_studies
Límite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Arch Surg
Año:
2010
Tipo del documento:
Article
País de afiliación:
Estados Unidos