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

Abstract

To determine the incidence of enterocutaneous fistulas (ECFs) developed after elective incisional hernia (IH) repair using intraperitoneal uncoated polypropylene (PPE) mesh. 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. 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 59months. Four (0.5%) patients required additional surgery due to intestinal occlusion. Neither acute nor chronic ECFs were encountered during follow-up in 695 patients. 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.