Impact of mesh use on morbidity following ventral hernia repair with a simultaneous bowel resection.
OBJECTIVE
To evaluate the impact of mesh use on outcomes following ventral hernia repairs and simultaneous bowel resection.


METHODS
Retrospective review.


METHODS
Teaching academic hospital.


METHODS
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).


METHODS
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.
Xourafas
Dimitrios
D
Department of Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA.
Lipsitz
Stuart R
SR
Negro
Paolo
P
Ashley
Stanley W
SW
Tavakkolizadeh
Ali
A
D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000601:surgery; D007414:Intestinal Neoplasms / Q000453:epidemiology / Q000601:surgery; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome