Abstract
Background: Ventral hernia repair (VHR) is one of the most common surgical procedures and is commonly associated with post procedural fluid collection formation. Purpose: To determine the clinical outcomes of percutaneous drainage of collections adjacent to mesh ventral hernia repair (VHR). Material and Methods: A retrospective review of all consecutive patients who underwent percutaneous drainage of fluid collections adjacent to mesh VHR was performed. Patient characteristics, mesh type, culture results, and clinical outcomes were reviewed. Clinical success was defined as mesh salvage and resolution of presenting signs and symptoms without surgical intervention. Results: A total of 14 patients were included (6 men, 8 women) with median age of 53 years (range: 22- 80 years). Median interval time between VHR and drain placement was 40 days (range: 15-1144 days). Pain was the most common presenting symptom, noted in 13 patients 93%), followed by erythema which was noted in 10 patients (71%). Percutaneous drain insertion was technically successful in all 14 patients (100%). Clinical success was achieved for five out of 14 patients (36%) whose mesh was salvaged. The other nine patients (64%) required mesh excision because of lack of clinical improvement. There was no statistically significant difference in drainage outcomes when comparing patient age, gender, mesh type, interval from surgery to drainage, or bacterial cultures. Conclusion: While percutaneous drainage of collections adjacent to mesh VHR may be successful in some cases, a majority of patients may ultimately require surgical mesh excision.
Highlights
Ventral hernia repair (VHR) is one of the most common procedures performed by general surgeons [1]
In order to reduce the risk of hernia recurrence, which is associated with the conventional suture repair technique, mesh repair has become a popular alternative for VHR [4]
The use of mesh for VHR has increased from approximately 30% in 1987 to over 65% in 1999 [9] as clinical trials have demonstrated mesh repair to be associated with a lower recurrence rate [4]
Summary
Ventral hernia repair (VHR) is one of the most common procedures performed by general surgeons [1]. While usually considered a relatively low-risk procedure, VHR is associated with a morbidity rate of up to 60% with complications including wound infection, seroma formation, reoperation, hospital readmission, and cardiovascular abnormalities [3]. In order to reduce the risk of hernia recurrence, which is associated with the conventional suture repair technique, mesh repair has become a popular alternative for VHR [4]. While mesh repair results in fewer cases of hernia recurrences, the rate of seroma formation and surgical site infection is higher compared with suture repair [4]. A retrospective record review of all consecutive patients who underwent percutaneous drainage of fluid collections adjacent to mesh VHR at our institution between June 2000 and December 2013 was performed. Images before and after the drainage procedures were reviewed using the picture archiving and communication system
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