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Published in: Techniques in Coloproctology 11/2016

01-11-2016 | Original Article

Incidence and surgical treatment of synthetic mesh-related infectious complications after laparoscopic ventral rectopexy

Authors: F. Borie, T. Coste, J. M. Bigourdan, F. Guillon

Published in: Techniques in Coloproctology | Issue 11/2016

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Abstract

Background

Prosthetic-related infection and erosion occurring after a laparoscopic ventral rectopexy (LVR) are rare complications, and their importance is often underestimated. The aim of this study was to compare the incidence rate and surgical management of these complications in LVR patients with polyester (PE) or polypropylene (PP) prostheses.

Methods

From January 2004 to June 2012, 149 patients underwent LVR with PE and 176 underwent LVR with PP. Surgical management and rate of infectious and erosive prosthesis-related complications, depending on the type of prosthesis, were described and compared. Functional results after complications were assessed.

Results

Five patients from the PE prosthesis group (3.3 %), compared with two patients from the PP prosthesis group (1.1 %), experienced prosthesis-related infection or erosion (p = 0.16). The rate of erosion alone was 3.3 % in patients with a PE prosthesis, and 0.55 % in patients with a PP prosthesis (p = 0.06). The average time until clinical diagnosis of a prosthesis-related complication was identical for both groups: 31 months (range 3–62 months). All patients underwent surgical removal of the prosthesis: For the five patients from the PE group, complete removal was performed by laparoscopy associated with a transanal procedure. For the two patients in the PP mesh group, laparoscopy was ineffective in removing the mesh which was partially removed through a subsequent transanal procedure. None of the patients had a protective stoma, and in all patients the complication had resolved 12 months after removal. Only one patient had worsening functional symptoms (fecal incontinence) after prosthesis removal.

Conclusions

When a prosthesis-related infection or erosion occurs, treatment consists in the surgical removal of the prosthesis by laparoscopy/and/or a transanal procedure. Functional symptoms do not routinely recur after prosthesis removal.
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Metadata
Title
Incidence and surgical treatment of synthetic mesh-related infectious complications after laparoscopic ventral rectopexy
Authors
F. Borie
T. Coste
J. M. Bigourdan
F. Guillon
Publication date
01-11-2016
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 11/2016
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-016-1538-z

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