Practice patterns in complex ventral hernia repair and place of biological grafts: a national survey among French digestive academic surgeons

Autor: Stéphane Benoist, Cécile Brigand, Antoine Hamy, N. Regenet, Sophie Deguelte, Nicolas Carrere, Guillaume Piessen, Denis Pezet, Christophe Tresallet, Mehdi Ouaissi, Bertrand Dousset, François Paye, P. Mathieu, François Lacaine, Denis Collet, Philippe Wind, J.-Y. Mabrut, Mustapha Adham, Yann Parc, Catherine Arvieux, N. Briez, Marc Pocard, S. Berdah, Christine Casa, R. Caiazzo, Muriel Mathonnet, Bernard Meunier, Christophe Laurent, J-M Toussaint, Charles Sabbagh, J-P Palot, J-C Gineste, Olivier Glehen, Christophe Mariette, Philippe Zerbib, Paul-Antoine Lehur, Vincent Dubuisson, François Pattou, Francis Michot, Micelli Lupinacci, Jean-Marc Regimbeau, Anne Berger
Přispěvatelé: Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, CHU Grenoble, Station Expérimentale, Institut Français du Cheval et de l'Equitation, Assistance Publique - Hôpitaux de Marseille (APHM), Aix-Marseille Université - École de médecine (AMU SMPM MED), Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM), Aix Marseille Université (AMU)-Aix Marseille Université (AMU), UMR1268, Biopolymères, Interactions Assemblages, Nantes, Institut National de la Recherche Agronomique (INRA), Département de chirurgie digestive, CHU Strasbourg, MMA, Laboratoire brestois de mécanique et des systèmes (LBMS), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Brest (UBO)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Brest (UBO)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Department of Oncologic Surgery, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), SAPHYN (SAnté et PHYsique Nucléaire), Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Psychiatrie et Psychologie Clinique de Liaison [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges], CHU Limoges, Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de chirurgie générale et digestive [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU Clermont-Ferrand, Hôpital Claude Huriez [Lille], CHU Lille, Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Amiens-Picardie, Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille], CHU Lille-CHU Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Biochemistry Unit, Georges Pompidou European Hospital, Paris Descartes University, AP-HP, Paris, France, Aix Marseille Université (AMU)-Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie Hépatobiliaire et Digestive [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Aix Marseille Université (AMU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Zdroj: Journal of Visceral Surgery
Journal of Visceral Surgery, Elsevier, 2014, 151 (1), pp.9-16. ⟨10.1016/j.jviscsurg.2013.12.001⟩
Journal of Visceral Surgery, 2014, 151 (1), pp.9-16. ⟨10.1016/j.jviscsurg.2013.12.001⟩
ISSN: 1878-7886
DOI: 10.1016/j.jviscsurg.2013.12.001⟩
Popis: International audience; BACKGROUND: Despite the prevalence of complex ventral hernias, there is little agreement on the most appropriate technique or prosthetic to repair these defects, especially in contaminated fields. Our objective was to determine French surgical practice patterns among academic surgeons in complex ventral hernia repair (CVHR) with regard to indications, most appropriate techniques, choice of prosthesis, and experience with complications.METHODS: A survey consisting of 21 questions and 6 case-scenarios was e-mailed to French practicing academic surgeons performing CVHR, representing all French University Hospitals.RESULTS: Forty over 54 surgeons (74%) responded to the survey, representing 29 French University Hospitals. Regarding the techniques used for CVHR, primary closure without reinforcement was provided in 31.6% of cases, primary closure using the component separation technique without mesh use in 43.7% of cases, mesh positioned as a bridge in 16.5% of cases, size reduction of the defect by using aponeurotomy incisions without mesh use in 8.2% of cases. Among the 40 respondents, 36 had experience with biologic mesh. There was a strong consensus among surveyed surgeons for not using synthetic mesh in contaminated or dirty fields (100%), but for using it in clean settings (100%). There was also a strong consensus between respondents for using biologic mesh in contaminated (82.5%) or infected (77.5%) fields and for not using it in clean setting (95%). In clean-contaminated surgery, there was no consensus for defining the optimal therapeutic strategy in CVHR. Infection was the most common complication reported after biologic mesh used (58%). The most commonly reported influences for the use of biologic grafts included literature, conferences and discussion with colleagues (85.0%), personal experience (45.0%) and cost (40.0%).CONCLUSIONS: Despite a lack of level I evidence, biologic meshes are being used by 90% of surveyed surgeons for CVHR. Importantly, there was a strong consensus for using them in contaminated or infected fields and for not using them in clean setting. To better guide surgeons, prospective, randomized trials should be undertaken to evaluate the short- and long-term outcomes associated with these materials in various surgical wound classifications.
Databáze: OpenAIRE
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