[en] The aim of this study was to compare prospectively the incidence of incisional hernia in two groups of patients operated on for morbid obesity, with or without intraperitoneal polyglactin mesh. From October 1990 to September 1993, a total of 288 patients were randomly assigned to the two groups. There were 144 patients in the mesh group and 144 in the no-mesh group. Altogether 240 patients (83%) were reviewed personally, 45 (16%) were interviewed by phone (n = 39) or mail (n = 6), and 3 (1%) were inaccessible for follow-up since discharge from the hospital. The mean follow-up period was 29.8 months (range 0-67 months). A total of 33 incisional hernias were observed in the mesh group and 41 in the no-mesh group. There was no significant difference in the distribution of herniation time between the two groups (p = 0.43). The two main predictive factors of herniation were age and weight. In conclusion, the use of an intraperitoneal polyglactin mesh does not prevent postoperative incisional hernias in obese patients.
Disciplines :
Surgery
Author, co-author :
Pans, Alain ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale - Clinique André Renard
Elen, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
Dewé, Walthère ; Université de Liège - ULiège > Analyse des médicaments
Desaive, Claude ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Language :
English
Title :
Long-Term Results of Polyglactin Mesh for the Prevention of Incisional Hernias in Obese Patients
Urschel, J.D., Scott, P.O., Williams, H.T.G.: Etiology of late develop-ing hernias: the positive role of mechanical stress. Med. Hypotheses 25:31, 1988
Champault, G.: Place des treillis résorbables dans le traitement des éventrations post-opératoires. J. Chir. (Paris) 7:27, 1988
Dumeige, F., André, J., Rignault, D.: Intérêt des treillis àrésorption lente en chirurgie abdominale: étude clinique apropos de cinquantecinq cas. Ann. Chir. 39:47, 1985
Samama, G., Garcia, J.C., Brefort, G.: Traitement des éviscérations par endoprothèses résorbables. Ann. Chir. 37:685, 1983
Pans, A., Desaive, C.: Use of an absorbable polyglactin mesh for the prevention of incisional hernias. Acta Chir. Belg. 95:265, 1995
Laws, H.: Standardized gastroplasty orifice. Am. J. Surg. 141:393, 1981
Kuzmak, L.I.: A review of seven years experience with silicone gastric banding. Obesity Surg. 7:403, 1992
Condon, R.E.: Incisional hernia. In Hernia, L.M. Nyhus, R.E. Condon, editors (4th ed.). Philadelphia, Lippincott, 1995, pp. 319-336
Mudge, M, Hughes, L.E.: Incisional hernia: a 10 years prospective study of incidence and attitudes. Br. J. Surg. 72:70, 1985
Ellis, H., Bucknall, T.E., Cox, P.J.: Abdominal incisions and their closure. Cur. Probl. Surg. 22(4):1, 1985
Hesselink, V.J., Luijendijk, R.W., de Wilt, J.H.W., Heide, R., Jeekel, J.: An evaluation of risk factors in incisional hernia recurrence. Surg. Gynecol. Obstet. 776:228, 1993
Chevrel, J.P., Flament, J.B.: Les Eventrations de la Paroi Abdominale. Paris, Masson, 1990, p. 30
Bajardi, G., Ricevuto, G., Mastrandrea, G., Latteri, M., Pischedda, G., Rubino, G., Valenti, D., Florena, M.: Il laparocele: complicanza tardiva délia chirurgia bariatrica. Minerva Chir. 48:331, 1993
Matory, W.E., Jr., O'Sullivan, J., Fudern, G., Dunn, R.: Abdominal surgery in patients with severe morbid obesity. Plast. Reconstr. Surg. 94:976, 1994
Thompson, W.R., Amaral, J.F., Caldwell, M.D., Martin, H.F., Randall, H.T.: Complications and weight loss in 150 consecutive gastric exclusion patients: critical review. Am. J. Surg. 146:602, 1983
