The use of synthetic mesh in patients undergoing ventral hernia repair during colorectal resection: risk of infection and recurrence

Galal H El-Gazzaz, Sherif H Farag, Mohamed A El-Sayd, Hatem H Mohamed
Asian Journal of Surgery 2012, 35 (4): 149-53

BACKGROUND/OBJECTIVE: The aim was to evaluate the risk of infection and hernia recurrence for patients undergoing repair of ventral hernia (VH) with prosthetic mesh during colorectal resection.

METHODS: A retrospective review was performed of long-term outcomes for 40 patients who underwent mesh repair for VH during bowel resection between 2000 and 2007. Patients with recurrence (R) were compared with others (NR) and univariate and multivariate analysis of factors associated with recurrence and infection were determined.

RESULTS: Forty patients (60% male, mean age 61 years) with colorectal cancer, diverticulitis and inflammatory bowel disease underwent repair with non-absorbable mesh. During the course of follow-up medical visits (median follow-up of 3.0 years; 25th percentile, 75th percentile: 1.8 years, 4.6 years), mesh infection rate was 22.5% and hernia recurrence rate 40%. R (n=16) and NR (n=24) had similar age, gender, body mass index, steroid use, smoking history, and drain use. A significantly greater proportion of R had diabetes (p=0.04), larger fascial defect (p=0.02), emergency surgery (p=0.001), and wound infection (p=0.001). On multivariate analysis, duration of follow-up (p=0.001), comorbidity (p=0.02), large defect size (p=0.04), emergency surgery (p=0.001) and development of infection (p=0.001) were the only factors independently associated with recurrence.

CONCLUSIONS: Use of non-absorbable mesh during colorectal resection should be very selective. Comorbidity, duration of follow-up, emergency operations, size of area covered and infection are independent factors associated with recurrence.

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