P-041 3-YEAR RETROSPECTIVE ANALYSIS OF USE OF ONLAY PROPHYLACTIC MESH IN MIDLINE LAPAROTOMY FOR GASTRIC CANCER

Abstract

Abstract Background Incisional hernias are a frequent complication of abdominal wall incisions, ranging from 12.8% to 69% in long-time series. Recent literature supports the use of prophylactic mesh placement to avoid long-term incisional hernias. Gastric surgery in our center is performed via midline laparotomy and prophylactic mesh placement is carried out as a usual practice. The objective of our study is to evaluate long-term results of prophylactic mesh in midline laparotomies for gastric cancer. Methods Observational retrospective analysis of all patients undergoing gastric cancer sugery via midline incision with use of a polypropliene autoadhesive prophylactic mesh, between the years 2019–2021. Outcome measures included demographics, comorbidities, wound complications, reinterventions, neoplastic recurrences and incisional hernias (diagnosed by CT scan). Results A cohort of 55 patients (80% male). Mean age 68.1 years old (41–86), BMI 25,75 kg/m2 (18.73–33). All patients operated for gastric cancer, abdominal wall closure with small bite technique (monofilament absorbable 2/0 suture) and autoadhesive onlay mesh. 72.7% distal subtotal gastrectomies. 89% elective surgery. Mean albumin in preoperative analytic 40.5 g/L. Postoperative complications: 72% Clavien-Dindo grade II, mean CCI 29 (including 4 reinterventions and 1 exitus). Mean follow-up 24.9 months: 8 (14.5%) neoplastic recurrences, 4 (7.3%) exitus for cancer progression and 3 (5.4%) incisional hernias diagnosed by CT Scan (none of them reoperated). No meshes have been removed. In a comparative study no risk factors for incisional hernia have been found. Conclusions In our setting, the use of polypropylene autoadhesive prophylactic meshes in midline incision for gastric cancer is safe and durable.