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Delorme T, Cottenet J, Abo-Alhassan F, Bernard A, Ortega-Deballon P, Quantin C. Does intraperitoneal mesh increase the risk of bowel obstruction? A nationwide French analysis. Hernia 2024; 28:419-426. [PMID: 37770815 DOI: 10.1007/s10029-023-02885-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION Incisional hernias are associated with a reduced quality of life. Mesh reinforcement of the abdominal wall is the current standard for incisional hernia repair (IHR), since it reduces the risk of recurrence. The best position for the mesh remains controversial, and each position has advantages and disadvantages. OBJECTIVE In this nationwide population-based study, we aimed to determine whether IHR with intraperitoneal mesh is associated with an increased risk of bowel obstruction. PATIENTS AND METHODS Using the French hospital database (PMSI), which collects data from all public and private hospitals, two patient cohorts were created and compared. Patients having undergone a laparoscopic IHR with intraperitoneal mesh (IPOM) in 2013 or 2014 due to a laparotomy performed in the 4 previous years were the IPOM group. Patients hospitalized for any other acute disease (i.e., without IHR) in 2013 and 2014, but having a similar laparotomy in the 4 previous years were the control group. Both cohorts were followed until 2019 in search of any episode of bowel obstruction. RESULTS A total of 815 patients were included in the IPOM group and matched to 1630 control patients. The 5 year bowel obstruction rate was 7.36% in the IPOM group and 4.42% in the control group (p < 0.01). In the multivariate analysis, after adjustment on age and obesity, incisional hernia repair with laparoscopic IPOM increased the risk of bowel obstruction in the 5 years following surgery (HR = 1.712; 95% CI 1.208-2.427; p = 0.0025). CONCLUSIONS Patients having undergone laparoscopic IPOM have an increased risk of bowel obstruction compared with patients who have a similar surgical history but no IHR.
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Affiliation(s)
- Théophile Delorme
- Department of Digestive Surgery, Dijon University Hospital, 14, Rue Paul Gaffarel, Dijon, 21079, France
| | - Jonathan Cottenet
- Department of Medical Information, Dijon University Hospital, Dijon, France
| | - Fawaz Abo-Alhassan
- Department of Digestive Surgery, Dijon University Hospital, 14, Rue Paul Gaffarel, Dijon, 21079, France
| | - Alain Bernard
- Department of Thoracic and Cardiovascular Surgery, Dijon University Hospital, Dijon, France
| | - Pablo Ortega-Deballon
- Department of Digestive Surgery, Dijon University Hospital, 14, Rue Paul Gaffarel, Dijon, 21079, France.
- INSERM, Université de Bourgogne, CHU Dijon Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France.
| | - Catherine Quantin
- Department of Medical Information, Dijon University Hospital, Dijon, France
- INSERM, Université de Bourgogne, CHU Dijon Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
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Han GR, Johnson ER, Jogerst KM, Calderon E, Hewitt WR, Pearson DG, Harold KL. Outcomes of a Large Series of Laparoscopic Ventral Hernia Repairs after Liver Transplantation. Am Surg 2023; 89:5520-5526. [PMID: 36827614 DOI: 10.1177/00031348231156762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND The hernia defects that develop in liver transplant recipients tend to be complex. Unfortunately, there is a paucity of data to guide post-transplant hernia management. Our goal was to evaluate the outcomes following laparoscopic ventral hernia repair (LVHR) in liver transplant recipients. METHODS A retrospective review of a prospectively kept database of liver transplant patients at a single tertiary healthcare facility was completed. All patients between 2007 and 2020 who underwent LVHR for a hernia at their transplant incision site were included. The primary outcome studied was hernia recurrence. Secondary outcomes included time-to-hernia repair, complications, and length of stay (LOS). RESULTS There were 89 patients who met inclusion criteria. 82% were male, mean age was 60 years, and mean body mass index was 30.2 kg/m2. 94.4% were on tacrolimus and 36% on mycophenolate mofetil. Median time-to-hernia repair was 16 months with a mean mesh size of 743 cm2 and length of stay of 3.7 days. None required conversion to an open operation. Postoperative complications included ileus (20.2%), acute kidney injury (11.2%), pneumonia (6.7%), and bleeding requiring re-operation (1.1%). Hernia-related complications included chronic suture site pain (1.1%), seroma requiring intervention (3.3%), surgical site infection (3.3%), nonoperative mesh infection (1.1%), and mesh infection requiring explantation (1.1%). Median follow-up was 23 months. Hernia recurrence occurred in 4.5% and no predictive variables for recurrence were identified. CONCLUSIONS Although the hernia defects that develop in liver transplant recipients are complex and their comorbidities significant, LVHR can safely and effectively repair these defects with low rates of recurrence and complications.
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Affiliation(s)
- Ga-Ram Han
- Department of General Surgery, Mayo Clinic, Phoenix, AZ, USA
| | | | | | | | | | - David G Pearson
- Department of General Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Kristi L Harold
- Department of General Surgery, Mayo Clinic, Phoenix, AZ, USA
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Kaufmann R, Jairam AP, Mulder IM, Wu Z, Verhelst J, Vennix S, Giesen LJX, Clahsen-van Groningen MC, Jeekel J, Lange JF. Non-Cross-Linked Collagen Mesh Performs Best in a Physiologic, Noncontaminated Rat Model. Surg Innov 2019; 26:302-311. [PMID: 30834819 PMCID: PMC6535808 DOI: 10.1177/1553350619833291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND In laparoscopic incisional hernia repair, direct contact between the prosthesis and abdominal viscera is inevitable and may lead to adhesions. Despite the large variety of mesh prosthesis, little is known about their in vivo behavior. Biological meshes are considered to have many advantages, but due to their price they are rarely used. A rat model was used to assess biological and conventional synthetic meshes on their in vivo characteristics. DESIGN One-hundred twenty male Wistar rats were randomized into five groups of 24 rats. A mesh was implanted intraperitoneally and fixated with nonresorbable sutures. The following five meshes were implanted: Parietene (polypropylene), Permacol (cross-linked porcine acellular dermal matrix), Strattice (non-cross-linked porcine acellular dermal matrix), XCM Biologic (non-cross-linked porcine acellular dermal matrix), and Omyra Mesh (condensed polytetrafluoroethylene). The rats were sacrificed after 30, 90, or 180 days. Incorporation, shrinkage, adhesions, abscess formation, and histology were assessed for all meshes. RESULTS All animals thrived postoperatively. After 180 days, Permacol, Parietene, and Omyra Mesh had a significantly better incorporation than Strattice ( P = .001, P = .019, and P = .037 respectively). After 180 days, Strattice had significantly fewer adhesions on the surface of the mesh than Parietene ( P < .001), Omyra Mesh ( P = .011), and Permacol ( P = .027). After 30 days, Permacol had significantly stronger adhesions than Strattice ( P = .030). However, this difference was not significant anymore after 180 days. After 180 days, there was significantly less shrinkage in Permacol than in Strattice ( P = .001) and Omyra Mesh ( P = .050). CONCLUSION Based on incorporation, adhesions, mesh shrinkage, and histologic parameters, Strattice performed best in this experimental rat model.
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Affiliation(s)
- Ruth Kaufmann
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - An P. Jairam
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Irene M. Mulder
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Zhouqiao Wu
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
- Gastrointestinal Cancer Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Joost Verhelst
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sandra Vennix
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Louis J. X. Giesen
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Johannes Jeekel
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Johan F. Lange
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
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Berrevoet F, Doerhoff C, Muysoms F, Hopson S, Muzi MG, Nienhuijs S, Kullman E, Tollens T, Schwartz MR, LeBlanc K, Velanovich V, Jørgensen LN. A multicenter prospective study of patients undergoing open ventral hernia repair with intraperitoneal positioning using the monofilament polyester composite ventral patch: interim results of the PANACEA study. Med Devices (Auckl) 2017; 10:81-88. [PMID: 28553149 PMCID: PMC5440003 DOI: 10.2147/mder.s132755] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose This study assessed the recurrence rate and other safety and efficacy parameters following ventral hernia repair with a polyester composite prosthesis (Parietex™ Composite Ventral Patch [PCO-VP]). Patients and methods A single-arm, multicenter prospective study of 126 patients undergoing open ventral hernia repair with the PCO-VP was performed. Patient outcomes were assessed at discharge and at 10 days, 1, 6, 12, and 24 months postoperative. Results All patients had hernioplasty for umbilical (n = 110, 87.3%) or epigastric hernia (n = 16, 12.7%). Mean hernia diameter was 1.8 ± 0.8 cm. Mean operative time was 36.2 ±15.6 minutes, with a mean mesh positioning time of 8.1 ± 3.4 minutes. Surgeons reported satisfaction with mesh ease of use in 95% of surgeries. The cumulative hernia recurrence rate at 1 year was 2.8% (3/106). Numeric Rating Scale (NRS) pain scores showed improvement from 2.1 ± 2.0 at preoperative baseline to 0.5 ± 0.7 at 1 month postoperative (P < 0.001), and this low pain level was maintained at 12 months postsurgery (P < 0.001). The mean global Carolina’s Comfort Scale® (CCS) score improved postoperatively from 3.8 ± 6.2 at 1 month to 1.6 ± 3.5 at 6 months (P < 0.001). One patient was unsatisfied with the procedure. Conclusion This 1-year interim analysis using PCO-VP for primary umbilical and epigastric defects shows promising results in terms of mesh ease of use, postoperative pain, and patient satisfaction. Recurrence rate is low, but, as laparoscopic evaluation shows a need for patch repositioning in some cases, an accurate surgical technique remains of utmost importance.
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Affiliation(s)
- Frederik Berrevoet
- Department of General and Hepatopancreaticobiliary Surgery, Ghent University Hospital, Ghent, Belgium
| | - Carl Doerhoff
- General Surgery, Surgicare of Missouri, Jefferson City, MO, USA
| | - Filip Muysoms
- Department of Surgery, AZ Maria Middelares Ghent, Ghent, Belgium
| | - Steven Hopson
- Bon Secours Hernia Center, Mary Immaculate Hospital, Newport News, VA, USA
| | | | | | | | - Tim Tollens
- Imelda Hospital-General Surgery Imelda Hospital, Bonheiden, Belgium
| | | | - Karl LeBlanc
- Our Lady of Lakes Regional Medical Center, Baton Rouge, LA
| | - Vic Velanovich
- Tampa General Hospital, University of South Florida, Tampa, FL, USA
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Woeste G, Juratli MA, Habbe N, Hannes S, El Youzouri H, Bechstein WO, Trombetta F, Moscato R, Ciamporcero T, Ghiglione F, Morino M, Tahir S, Baldjiev T, Goshev G, Pachoov N, Eftimov E, Kovachevski S, Smirnoff A, Roth JS, Wennergren J, Plymale MA, Zachem A, Davenport DL, Mangiante G, Passeri V, deManzoni G, Kaufmann R, Jairam AP, Mulder IM, Wu Z, Verhelst J, Vennix S, Giessen LJX, Jeekel J, Lange JF, Di Cerbo F, Ikhlawi K, Baladov M, Agha A, Iesalnieks I, Franklin M, Hernandez M, Glass J, Glover M, Gruber-Blum S, Fortelny R, May C, Glaser K, Redl H, Petter-Puchner A, Grossi J, Cavazzola LT, Tezza SLT, Nery LA, Zortea J, Roll S, Gorganchian F, Santa Maria V, Zuvela M, Galun D, Petrovic J, Micev M, Palibrk I, Bidzic N, Colozzi S, Clementi M, Cianca G, Giuliani A, Carlei F, Schietroma M, Amicucci G, Chung M, Cerasani N, Meyer J, Bulian DR, Heiss MM, Kocaay AF, Eker T, Celik SU, Akyol C, Cakmak A. Topic: Abdominal Wall Hernia - Abdominal wall closure. Hernia 2015; 19 Suppl 1:S198-205. [PMID: 26518800 DOI: 10.1007/bf03355349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- G Woeste
- Department of Surgery, Goethe university, Frankfurt, Germany
| | - M A Juratli
- Department of Surgery, Goethe university, Frankfurt, Germany
| | - N Habbe
- Department of Surgery, Goethe university, Frankfurt, Germany
| | - S Hannes
- Department of Surgery, Goethe university, Frankfurt, Germany
| | - H El Youzouri
- Department of Surgery, Goethe university, Frankfurt, Germany
| | - W O Bechstein
- Department of Surgery, Goethe university, Frankfurt, Germany
| | - F Trombetta
- SCDU General Surgery 1, University of Turin, Company City Hospital and Healht Science of Turin, Turin, Italy
| | - R Moscato
- SCDU General Surgery 1, University of Turin, Company City Hospital and Healht Science of Turin, Turin, Italy
| | - T Ciamporcero
- SCDU General Surgery 1, University of Turin, Company City Hospital and Healht Science of Turin, Turin, Italy
| | - F Ghiglione
- SCDU General Surgery 1, University of Turin, Company City Hospital and Healht Science of Turin, Turin, Italy
| | - M Morino
- SCDU General Surgery 1, University of Turin, Company City Hospital and Healht Science of Turin, Turin, Italy
| | - S Tahir
- University Surgical Clinic St. Naum Ohridski, Skopje, R. of Macedonia, European Union
| | - T Baldjiev
- General Hospital, Strumica, Public Health Organization, Strumica, R. of Macedonia, European Union
| | - G Goshev
- General Hospital, Strumica, Public Health Organization, Strumica, R. of Macedonia, European Union
| | - N Pachoov
- General Hospital, Strumica, Public Health Organization, Strumica, R. of Macedonia, European Union
| | - E Eftimov
- General Hospital, Strumica, Public Health Organization, Strumica, R. of Macedonia, European Union
| | - S Kovachevski
- General Hospital, Strumica, Public Health Organization, Strumica, R. of Macedonia, European Union
| | | | - J S Roth
- Department of Surgery, University of Kentucky, Lexington, KY, USA
| | - J Wennergren
- Department of Surgery, University of Kentucky, Lexington, KY, USA
| | - M A Plymale
- Department of Surgery, University of Kentucky, Lexington, KY, USA
| | - A Zachem
- Department of Surgery, University of Kentucky, Lexington, KY, USA
| | - D L Davenport
- Department of Surgery, University of Kentucky, Lexington, KY, USA
| | - G Mangiante
- Upper Digestive Surgery, University of Verona, Verona, Italy
| | | | | | - R Kaufmann
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - A P Jairam
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - I M Mulder
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Surgery, Academic Medical Center, Amsterdam, Netherlands
| | - Z Wu
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J Verhelst
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - S Vennix
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Surgery, Academic Medical Center, Amsterdam, Netherlands
| | - L J X Giessen
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J Jeekel
- Department of Neuroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J F Lange
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - K Ikhlawi
- Marienhospital Gelsenkirchen, Gelsenkirchen, Germany
| | - M Baladov
- Marienhospital Gelsenkirchen, Gelsenkirchen, Germany
| | - A Agha
- Klinikum Bogenhausen, Munich, Germany
| | | | - M Franklin
- Texas endosurgery Institute, San Antonio, USA
| | - M Hernandez
- Texas endosurgery Institute, San Antonio, USA
| | - J Glass
- Texas endosurgery Institute, San Antonio, USA
| | - M Glover
- Texas endosurgery Institute, San Antonio, USA
| | - S Gruber-Blum
- Department of General, Visceral and Oncologic Surgery, Wilhelminenspital, Vienna, Austria
| | - R Fortelny
- Department of General, Visceral and Oncologic Surgery, Wilhelminenspital, Vienna, Austria
| | - C May
- Department of General, Visceral and Oncologic Surgery, Wilhelminenspital, Vienna, Austria
| | - K Glaser
- Department of General, Visceral and Oncologic Surgery, Wilhelminenspital, Vienna, Austria
| | - H Redl
- Cluster of Tissue engeneering, Ludwig Boltzmann Institute of Traumatology, Vienna, Austria
| | - A Petter-Puchner
- Department of General, Visceral and Oncologic Surgery, Wilhelminenspital, Vienna, Austria
| | - J Grossi
- Brazilian lutern hospital, Canoas, Brazil
| | | | | | | | | | | | - F Gorganchian
- Departamento de Cirugia, Instituto de Investigaciones Medicas A. Lanari, Caba, Argentina
| | - V Santa Maria
- Departamento de Cirugia, Instituto de Investigaciones Medicas A. Lanari, Caba, Argentina
| | - M Zuvela
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
- Medical School, University of Belgrade, Belgrade, Serbia
| | - D Galun
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
- Medical School, University of Belgrade, Belgrade, Serbia
| | - J Petrovic
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
| | - M Micev
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
- Medical School, University of Belgrade, Belgrade, Serbia
| | - I Palibrk
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
- Medical School, University of Belgrade, Belgrade, Serbia
| | - N Bidzic
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
| | - S Colozzi
- Ospedale Civile San Salvatore, L'Aquila, Italy
| | | | | | | | | | | | | | - M Chung
- Gil Medical Center, Gachon University, Incheon, South Korea
| | - N Cerasani
- Department of Abdominal-, Vascular and Transplant Surgery, Cologne-Merheim Medical Center University of Witten/Herdecke, Cologne, Germany
| | - J Meyer
- Department of Abdominal-, Vascular and Transplant Surgery, Cologne-Merheim Medical Center University of Witten/Herdecke, Cologne, Germany
| | - D R Bulian
- Department of Abdominal-, Vascular and Transplant Surgery, Cologne-Merheim Medical Center University of Witten/Herdecke, Cologne, Germany
| | - M M Heiss
- Department of Abdominal-, Vascular and Transplant Surgery, Cologne-Merheim Medical Center University of Witten/Herdecke, Cologne, Germany
| | - A F Kocaay
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - T Eker
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - S U Celik
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - C Akyol
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - A Cakmak
- Department of General Surgery, Ankara University School of Medicine, Ankara, Turkey
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