RT Journal
A1 Xourafas D, Lipsitz SR, Negro P, Ashley SW, Tavakkolizadeh A
T1 IMpact of mesh use on morbidity following ventral hernia repair with a simultaneous bowel resection
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD August 1
VO 145
IS 8
SP 739
OP 744
DO 10.1001/archsurg.2010.144
UL http://dx.doi.org/10.1001/archsurg.2010.144
AB Objective 
    To evaluate the impact of mesh use on outcomes following ventral hernia repairs and simultaneous bowel resection.Design 
    Retrospective review.Setting 
    Teaching academic hospital.Patients 
    We studied 177 patients who underwent a ventral hernia repair with a bowel resection between May 1, 1992, and May 30, 2007. A prosthesis was used in 51 repairs (mesh group), while 126 repairs were primary (mesh-free group).Main Outcome Measures 
    Demographic characteristics, comorbidities, mesh type, bowel resection type (colon vs small bowel), defect size, drain use, and length of hospital stay were compared between groups with Fisher exact test and multivariate analysis.Results 
    There were no statistically significant differences between patient characteristics and relevant comorbidities. The incidence of postoperative infection (superficial or deep) was 22% in the mesh group vs 5% in the mesh-free group (P = .001). Other complications (fistula, seroma, hematoma, bowel obstruction) occurred in 24% of patients in the mesh group vs 8% of patients in the mesh-free group (P = .009). Focusing on the patients who developed an infection, prosthetic mesh use was the only significant risk factor on multivariate regression analysis, irrespective of drain use, defect size, and type of bowel resection.Conclusions 
    We recommend caution in using mesh when performing a ventral hernia repair with a simultaneous bowel resection because of significantly increased postoperative infectious complications. Drain use, defect size, and bowel resection type did not influence outcomes.