Skip to main content
Top
Published in: Hernia 1/2017

01-02-2017 | Original Article

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

Authors: C. D. Brandi, S. Roche, S. Bertone, M. E. Fratantoni

Published in: Hernia | Issue 1/2017

Login to get access

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.
Literature
2.
go back to reference Vrijland WW, Jeekel J, Steyerberg EW, den Hoed PT, Bonjer HJ (2000) Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula. Br J Surg 87:348–352CrossRefPubMed Vrijland WW, Jeekel J, Steyerberg EW, den Hoed PT, Bonjer HJ (2000) Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula. Br J Surg 87:348–352CrossRefPubMed
3.
go back to reference Bernard C, Polliand C, Mutelica L, Champault G (2007) Repair of giant incisional abdominal wall hernias using open intraperitoneal mesh. Hernia 11:315–320CrossRefPubMed Bernard C, Polliand C, Mutelica L, Champault G (2007) Repair of giant incisional abdominal wall hernias using open intraperitoneal mesh. Hernia 11:315–320CrossRefPubMed
4.
go back to reference Coda A, Lamberti R, Martorana S (2012) Classification of prosthetics used in hernia repair based on weight and biomaterial. Hernia 16:9–20CrossRefPubMed Coda A, Lamberti R, Martorana S (2012) Classification of prosthetics used in hernia repair based on weight and biomaterial. Hernia 16:9–20CrossRefPubMed
5.
go back to reference Klinge U, Conze J, Krones CJ, Schumpelick V (2005) Incisional hernia: open techniques. World J Surg 29:1066–1072CrossRefPubMed Klinge U, Conze J, Krones CJ, Schumpelick V (2005) Incisional hernia: open techniques. World J Surg 29:1066–1072CrossRefPubMed
7.
go back to reference Hamy A, Pessaux P, Mucci-Hennekinne S et al (2003) Surgical treatment of large incisional hernias by an intraperitoneal Dacron mesh and an aponeurotic graft. J Am Coll Surg 196:531–534CrossRefPubMed Hamy A, Pessaux P, Mucci-Hennekinne S et al (2003) Surgical treatment of large incisional hernias by an intraperitoneal Dacron mesh and an aponeurotic graft. J Am Coll Surg 196:531–534CrossRefPubMed
8.
go back to reference Franklin ME, Dorman JP, Glass JL, Balli JE, González JJ (1998) Laparoscopic ventral and incisional hernia repair. Surg Laparosc Endosc 8:294–299CrossRefPubMed Franklin ME, Dorman JP, Glass JL, Balli JE, González JJ (1998) Laparoscopic ventral and incisional hernia repair. Surg Laparosc Endosc 8:294–299CrossRefPubMed
9.
go back to reference Fry DE et al (2001) Infected abdominal wall prosthesis. In: Bendavid R (ed) Abdominal wall hernias: principles and management. (part XVII). Springer, New York, pp 707–713 Fry DE et al (2001) Infected abdominal wall prosthesis. In: Bendavid R (ed) Abdominal wall hernias: principles and management. (part XVII). Springer, New York, pp 707–713
10.
go back to reference Rudmik LR, Schieman C, Dixon E, Debru E (2006) Laparoscopic incisional hernia repair: a review of the literature. Hernia 10:110–119CrossRefPubMed Rudmik LR, Schieman C, Dixon E, Debru E (2006) Laparoscopic incisional hernia repair: a review of the literature. Hernia 10:110–119CrossRefPubMed
11.
go back to reference Usher FC, Ochsner J, Tuttle LLJ (1958) Use of Marlex mesh in the repair of incisional hernias. Am Surg 24:969–974PubMed Usher FC, Ochsner J, Tuttle LLJ (1958) Use of Marlex mesh in the repair of incisional hernias. Am Surg 24:969–974PubMed
12.
go back to reference Usher FC (1979) New technique for repairing incisional hernias with marlex mesh. Am J Surg 138:740–741CrossRefPubMed Usher FC (1979) New technique for repairing incisional hernias with marlex mesh. Am J Surg 138:740–741CrossRefPubMed
13.
go back to reference Kaufman Z, Engelberg M (1981) Fecal fistula: a late complication of Marlex mesh repair. Dis Colon Rectum 24:543–544CrossRefPubMed Kaufman Z, Engelberg M (1981) Fecal fistula: a late complication of Marlex mesh repair. Dis Colon Rectum 24:543–544CrossRefPubMed
16.
go back to reference Leber GE, Garb JL, Alexander AI, Reed WP (1998) Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382CrossRefPubMed Leber GE, Garb JL, Alexander AI, Reed WP (1998) Long-term complications associated with prosthetic repair of incisional hernias. Arch Surg 133:378–382CrossRefPubMed
17.
go back to reference Chew DKW, Choi LH, Roger AM (2000) Enterocutaneous fistula 14 years after prosthetic mesh repair of a ventral incisional hernia: a life-long risk? Surgery 127:352–353CrossRefPubMed Chew DKW, Choi LH, Roger AM (2000) Enterocutaneous fistula 14 years after prosthetic mesh repair of a ventral incisional hernia: a life-long risk? Surgery 127:352–353CrossRefPubMed
18.
go back to reference Ott V, Groebli Y, Schneider R (2005) Late intestinal fistula formation after incisional hernia using intraperitoneal mesh. Hernia 9:103–104CrossRefPubMed Ott V, Groebli Y, Schneider R (2005) Late intestinal fistula formation after incisional hernia using intraperitoneal mesh. Hernia 9:103–104CrossRefPubMed
19.
go back to reference Burger JWA, Luijendijk RW, Hop WCJ et al (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–585PubMedPubMedCentral Burger JWA, Luijendijk RW, Hop WCJ et al (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–585PubMedPubMedCentral
20.
go back to reference McLanahan D, King LT, Weems C, Novotney M, Gibson K (1997) Retrorectus prosthetic mesh repair of midline abdominal hernia. Am J Surg 173:445–449CrossRefPubMed McLanahan D, King LT, Weems C, Novotney M, Gibson K (1997) Retrorectus prosthetic mesh repair of midline abdominal hernia. Am J Surg 173:445–449CrossRefPubMed
21.
go back to reference Adloff M, Arnaud JP (1987) Surgical management of large incisional hernias by an intraperitoneal mersilene mesh and an aponeurotic graft. Surg Gynecol Obst 165:204–206 Adloff M, Arnaud JP (1987) Surgical management of large incisional hernias by an intraperitoneal mersilene mesh and an aponeurotic graft. Surg Gynecol Obst 165:204–206
22.
go back to reference Arnaud JP, Cervi C, Tuech JJ, Cattan F (1997) Surgical treatment of post-operative incisional hernias by intra-peritoneal insertion of a Dacron mesh. A report on 220 cases. Hernia 1:97–99CrossRef Arnaud JP, Cervi C, Tuech JJ, Cattan F (1997) Surgical treatment of post-operative incisional hernias by intra-peritoneal insertion of a Dacron mesh. A report on 220 cases. Hernia 1:97–99CrossRef
23.
24.
25.
go back to reference DeGuzman LJ, Nyhus LM, Yared G, Schlesinger PK (1995) Colocutaneous fistula formation following polypropylene mesh placement for repair of a ventral hernia: diagnosis by colonoscopy. Endoscopy 27:459–461CrossRefPubMed DeGuzman LJ, Nyhus LM, Yared G, Schlesinger PK (1995) Colocutaneous fistula formation following polypropylene mesh placement for repair of a ventral hernia: diagnosis by colonoscopy. Endoscopy 27:459–461CrossRefPubMed
26.
go back to reference Wantz GE et al (1999) Incisional hernias symposium. Incisional hernia: the problem and the cure. J Am Coll Surg 188:429–447CrossRef Wantz GE et al (1999) Incisional hernias symposium. Incisional hernia: the problem and the cure. J Am Coll Surg 188:429–447CrossRef
27.
go back to reference Afifi RY (2005) A prospective study between two different techniques for the repair of a large recurrent ventral hernia: a double mesh intraperitoneal repair versus onlay mesh repair. Hernia 9:310–315CrossRefPubMed Afifi RY (2005) A prospective study between two different techniques for the repair of a large recurrent ventral hernia: a double mesh intraperitoneal repair versus onlay mesh repair. Hernia 9:310–315CrossRefPubMed
28.
go back to reference Halm J, de Wall L, Steyerberg W et al (2007) Intraperitoneal polypropylene mesh repair complicates subsequent abdominal surgery. World J Surgery 31:423–429CrossRef Halm J, de Wall L, Steyerberg W et al (2007) Intraperitoneal polypropylene mesh repair complicates subsequent abdominal surgery. World J Surgery 31:423–429CrossRef
Metadata
Title
No enterocutaneous fistula development in a cohort of 695 patients after incisional hernia repair using intraperitoneal uncoated polyproylene mesh
Authors
C. D. Brandi
S. Roche
S. Bertone
M. E. Fratantoni
Publication date
01-02-2017
Publisher
Springer Paris
Published in
Hernia / Issue 1/2017
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-016-1530-6

Other articles of this Issue 1/2017

Hernia 1/2017 Go to the issue