Incisional hernia prevention using a cyanoacrilate-fixed retrofascial mesh.

Autor: Hoyuela C; Servicio de Cirugía Digestiva, Hospital Platón Barcelona, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: carloshoyuela@gmail.com., Juvany M; Servicio de Cirugía Digestiva, Hospital Platón Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Trias M; Servicio de Cirugía Digestiva, Hospital Platón Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Ardid J; Servicio de Cirugía Digestiva, Hospital Platón Barcelona, Universitat Autònoma de Barcelona, Barcelona, España., Martrat A; Servicio de Cirugía Digestiva, Hospital Platón Barcelona, Universitat Autònoma de Barcelona, Barcelona, España.
Jazyk: English; Spanish; Castilian
Zdroj: Cirugia espanola [Cir Esp (Engl Ed)] 2018 Jan; Vol. 96 (1), pp. 35-40. Date of Electronic Publication: 2017 Dec 15.
DOI: 10.1016/j.ciresp.2017.10.003
Abstrakt: Introduction: The rate of incisional hernia in high-risk patients (obesity, cancer, etc.) is high, even in laparoscopic surgery. The aim of this study is to evaluate the safety of the use of cyanoacrylate fixed prophylactic meshes in the assistance incision in overweight or obese patients undergoing laparoscopic colorectal surgery.
Methods: A prospective, non-randomized cohort study of patients undergoing elective laparoscopic resection for colorectal cancer between January 2013 and March 2016 was performed. Those with a body mass index greater than 25kg / m 2 were evaluated to implant a prophylactic meshes fixed with cyanoacrylate (Histoacryl®) as reinforcement of the assistance incision.
Results: 52 patients were analyzed (mean body mass index: 28.4±2kg / m 2 ). Prophylactic meshes was implanted in 15 patients. The time to put the mesh in place was always less than 5minutes. There was no significant difference in wound infection rate (12% vs. 10%). No mesh had to be explanted. Although the mean follow-up was shorter (14.1±4 vs. 22.3±9 months), there were no incisional hernia in the mesh group. On the other hand, in the non-mesh group, 1 acute evisceration (2.7%) and 4 incisional hernia of the assistance incision were observed (10.8%). There were no significant differences between groups regarding trocar incisional hernia (6.6 vs. 5.4%).
Conclusions: The implantation of a reinforcement prophylactic mesh in overweight or obese patients undergoing laparoscopic colorectal surgery is safe and seems to reduce the short-term rate of incisional hernia. Fixation with cyanoacrylate is a rapid method that facilitates the procedure without additional complications.
(Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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