Search

Summary: Aims of the study: To evaluate post-operative complications and the recurrence rate after repair of large ventral incisional hernia with an open technique using intraperitoneal composite mesh and an associated aponeurotic overlay. Patients and methods: This prospective study included a total of 280 patients who underwent repair of large incisional hernia using Parietex® composite mesh. Results: The post-operative mortality rate was 0.35%. Six patients (2%) developed subcutaneous surgical site infection without infection of the prosthesis. Six other patients (2%) developed a deep-seated infection; in three cases, the mesh had to be removed. Nine patients (3.2%) developed recurrent incisional hernia. Conclusion: Large ventral incisional hernias can be effectively treated by the intraperitoneal placement of Parietex® composite mesh overlaid by an aponeurotic graft; the incidence of complications in this prospective study was very low. [ABSTRACT FROM AUTHOR]

The morbidity from colorectal surgery can be high and increases for patients with cirrhosis of the liver. This study was designed to assess morbidity, mortality, and prognostic factors for patients with cirrhosis undergoing colorectal surgery. From 1993 to 2006, 41 cirrhotic patients underwent 43 colorectal procedures and were included. Both univariate and multivariate analyses were performed to identify variables influencing morbidity and mortality. Postoperative morbidity was 77 percent (33/43). Postoperative mortality was 26 percent (11/43) among whom six patients (54 percent) underwent emergency surgery. Four factors influenced mortality on univariate analysis: presence of peritonitis ( P < 0.05), postoperative complications ( P < 0.04), postoperative infections ( P < 0.01), and total colectomy procedures ( P < 0.02). On multivariate analysis, the only factor influencing mortality was postoperative infection ( P < 0.04). The only factor influencing morbidity was the existence of preoperative ascites ( P < 0.04). Colorectal surgery for cirrhotic patients has a high risk of morbidity and mortality. This risk is associated with the presence of infection, ascitic decompensation, and the urgent or extensive nature of the procedure. The optimization of patients through selection and preparation reduces operative risk. [ABSTRACT FROM AUTHOR]