Technique and complications of reconstruction of the pelvic floor with polyglactin mesh.
A polyglactin mesh sling was used to reconstruct the pelvis in eight patients after colorectal or urologic resections in preparation for postoperative radiation therapy. There were three perioperative complications--a pelvic abscess requiring percutaneous drainage, a wound dehiscence and a herniation of the small intestine between the pelvic sidewall and mesh requiring small intestinal resection. There were two delayed complications, both partial small intestinal obstructions. One occurred just after the conclusion of radiation treatment and the other occurred five months after the conclusion of radiation therapy. Both obstructions responded to conservative management. None of the common acute radiation effects occurred during radiotherapy. One patient with delayed partial small intestinal obstruction had possible late radiation effects. The median follow-up period after radiation therapy was 12.5 months. Despite the complications described in this report, the use of a polyglactin mesh sling as an adjunct to resection of carcinoma of the pelvis has merit and should be studied further.
Sener
S F
SF
Department of Surgery, Evanston Hospital, Illinois 60201.
Imperato
J P
JP
Blum
M D
MD
Ignatoff
J M
JM
Soper
T G
TG
Winchester
D P
DP
Meiselman
M
M
D000368:Aged; D015179:Colorectal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D006547:Hernia / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011098:Polyglactin 910; D011108:Polymers; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology*; D011832:Radiation Injuries / Q000517:prevention & control; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014571:Urologic Neoplasms / Q000532:radiotherapy / Q000601:surgery*
D011108:Polymers; D011098:Polyglactin 910