Introduction/Background Incisional hernias are a frequent complication of midline laparotomies in abdominal surgery. This study was conducted in order to determine the efficacy and safety of mesh placement in reducing incisional hernia rate in patients treated for ovarian carcinomas through midline laparotomy.
Methodology Retrospective data from patients undergoing midline laparotomy for borderline or ovarian cancer were collected. Patients were stratified according individual risk factors for incisional hernia. Incidence of incisional hernia according to mesh placement and fascia closure technique (small bites vs. large bites) was assessed at patients with at least 12 months follow-up. Short and long-term complications were also assessed in both groups (mesh and no mesh).
Results In total, 139 patients with available data for follow-up were included. After clinical and radiological examination 18.71% (26/139) of patients developed incisional hernia. Of all 26 incisional hernias, 18 (69.2%) were detected in non-mesh group, whereas 8 (30.8%) in mesh group (p<0.002). A univariate analysis revealed that malnutrition (albumin<3mg/dL), non-mesh placement and large bites technique were significant risk factors for hernia development. An increased risk of wound complications (seroma and wound dehiscence) was reported in mesh group, without impact on the time to adjuvant chemotherapy.
Conclusion The addition of a prophylactic mesh may reduce the incidence of incisional hernia in ovarian cancer patients, without adding a substantial rate of morbidity.
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