title: Surgery for chronic mesh infection occurred 10 years after sacrectomy - Mesh resection and mesentric leaf repair: A case report.
abstract: BACKGROUND
  Sacrectomy to treat malignant tumors is often results in large pelvic defects to require reconstruction, using a prosthetic mesh. Importance is to avoid its direct contact of mesh with intestine to prevent adhesion between them.
  
  
  METHODS
  An 83-year old woman who was diagnosed with a mesh infection caused by a small bowel penetration 10 years after sacrectomy combined with mesh reconstruction for chordoma. In the first operation, because of incomplete re-peritonealization due to a large defect in the retroperitoneum, a mesh unavoidably was compelled to contact with the small intestine. We subtotally removed the mesh and performed mesentric leaf repair of the pelvic defect. The postoperative course was complicated by infection of the pelvis. She was discharged 59days after surgery with a little purulent discharge from perineal wound, which was persisted for two years after operation.
  
  
  CONCLUSIONS
  We used the mesenteric leaf to repair the pelvic defect at the operation. This procedure might be the best alternative, when the use of mesh has to be avoided like present case. To our knowledge, this is the first report of mesh infection after sacrectomy, so we report herein.
authors.affiliation: Shinshu University School of Medicine Department of digestive surgery, 3-1-1 Asahi, Matsumoto 390-8621, Japan. Electronic address: makotokoma8810@yahoo.co.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Koyama
authors.affiliation: Shinshu University School of Medicine Department of digestive surgery, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Miyagawa
authors.affiliation: Shinshu University School of Medicine Department of digestive surgery, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Shinshu University School of Medicine Department of digestive surgery, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kitazawa
authors.affiliation: Shinshu University School of Medicine Department of digestive surgery, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: North Alps Medical center Azumi Hospital, Deprtment of Surgery, 1-3207 Ikeda-cho, Kitaazumi-gun, 399-8695, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishizone
authors.affiliation: Shinshu University School of Medicine Department of digestive surgery, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyagawa
keywords: Case report; Chronic mesh infection; Mesenteric leaf repair; Pelvic reconstruction; Sacrectomy