Incidence and surgical treatment of synthetic mesh-related infectious complications after laparoscopic ventral rectopexy

Autor: F. Borie, F. Guillon, T. Coste, J. M. Bigourdan
Přispěvatelé: Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Time Factors
Complications
medicine.medical_treatment
Prosthesis
Transanal Endoscopic Surgery
0302 clinical medicine
Fecal incontinence
Postoperative Period
Laparoscopy
medicine.diagnostic_test
Incidence
Rectocele
Gastroenterology
Middle Aged
Colorectal surgery
Prosthesis Failure
Treatment Outcome
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
Rectopexy
medicine.symptom
Adult
medicine.medical_specialty
Synthetic mesh
Prosthesis-Related Infections
Polyesters
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
Polypropylenes
Prosthesis Design
03 medical and health sciences
Laparoscopic
medicine
Humans
Device Removal
Aged
Retrospective Studies
business.industry
Rectum
[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Rectal Prolapse
Surgical Mesh
medicine.disease
Surgery
Rectal prolapse
Surgical mesh
business
Follow-Up Studies
Abdominal surgery
Zdroj: Techniques in Coloproctology
Techniques in Coloproctology, Springer Verlag (Germany), 2016, 20 (11), pp.759-765. ⟨10.1007/s10151-016-1538-z⟩
ISSN: 1123-6337
1128-045X
DOI: 10.1007/s10151-016-1538-z⟩
Popis: International audience; BACKGROUND:Prosthetic-related infection and erosion occurring after a laparoscopic ventral rectopexy (LVR) are rare complications, and their importance is often underestimated. The aim of this study was to compare the incidence rate and surgical management of these complications in LVR patients with polyester (PE) or polypropylene (PP) prostheses.METHODS:From January 2004 to June 2012, 149 patients underwent LVR with PE and 176 underwent LVR with PP. Surgical management and rate of infectious and erosive prosthesis-related complications, depending on the type of prosthesis, were described and compared. Functional results after complications were assessed.RESULTS:Five patients from the PE prosthesis group (3.3 %), compared with two patients from the PP prosthesis group (1.1 %), experienced prosthesis-related infection or erosion (p = 0.16). The rate of erosion alone was 3.3 % in patients with a PE prosthesis, and 0.55 % in patients with a PP prosthesis (p = 0.06). The average time until clinical diagnosis of a prosthesis-related complication was identical for both groups: 31 months (range 3-62 months). All patients underwent surgical removal of the prosthesis: For the five patients from the PE group, complete removal was performed by laparoscopy associated with a transanal procedure. For the two patients in the PP mesh group, laparoscopy was ineffective in removing the mesh which was partially removed through a subsequent transanal procedure. None of the patients had a protective stoma, and in all patients the complication had resolved 12 months after removal. Only one patient had worsening functional symptoms (fecal incontinence) after prosthesis removal.CONCLUSIONS:When a prosthesis-related infection or erosion occurs, treatment consists in the surgical removal of the prosthesis by laparoscopy/and/or a transanal procedure. Functional symptoms do not routinely recur after prosthesis removal.
Databáze: OpenAIRE
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