@article{3119342, title = "Intestinal erosions following inguinal hernia repair: a systematic review", author = "Koliakos, N. and Papaconstantinou, D. and Nastos, C. and Kirkilesis, G. and Bompetsi, G. and Bakopoulos, A. and Ntomi, V. and Pikoulis, E.", journal = "Revista Hispanoamericana de Hernia", year = "2021", volume = "25", number = "5", pages = "1137-1145", publisher = "Springer-Verlag Italia s.r.l.", issn = "2255-2677", doi = "10.1007/s10029-020-02324-1", keywords = "abdominal distension; abdominal pain; adult; clinical outcome; comparative study; controlled study; device failure; device removal; diarrhea; fatality; female; follow up; gastrointestinal symptom; hernia mesh erosion; hernioplasty; human; inguinal hernia; intestine injury; intestine obstruction; intestine resection; male; medical device complication; middle aged; minimally invasive procedure; morbidity; mortality; multiple organ failure; palpable inguinal mass; postoperative complication; postoperative period; rectum hemorrhage; Review; risk factor; systematic review; urinary tract disease; adverse device effect; adverse event; herniorrhaphy; inguinal region; laparoscopy; surgical mesh, Groin; Hernia, Inguinal; Herniorrhaphy; Humans; Laparoscopy; Surgical Mesh", abstract = "Purpose: To sum all available evidence regarding mesh or mesh fixation material intestinal erosion following inguinal hernia repair and identify the parameters that lead to early (< 6 months) versus late (> 6 months) symptom presentation. Methods: A systematic literature search of the MEDLINE, Scopus and Google Scholar databases was undertaken to identify relevant studies published up to June 2020. Results: A total of 54 case reports or cases series, incorporating 57 intestinal erosions were identified. Overall, 13 patients (23%) experienced early intestinal erosions occurring during the first 6 postoperative months while the remaining 44 events (67%) occurred after 6 months. Patients presented most commonly with symptoms of acute obstruction (n = 18, 31.5%), followed by signs of a palpable inguinal mass in 15 patients (26.3%). The late presentation group exhibited significantly more cases of mesh erosion when compared to the early presentation group (100% versus 46.2%, respectively, p < 0.001). Conversely, early presenting cases were more often associated with mesh fixation material erosion (53.8% versus 6.8% in the late group, p < 0.001) and were more likely to develop symptoms of acute intestinal obstruction (61.5% versus 22.8%, p = 0.01). An open primary procedure was more common in late presenting cases (65.9% versus 7.7%, p < 0.001) while early presentation was linked to minimally invasive primary procedures (92.3% versus 34.2%, p < 0.001). Bowel resection was more frequently required in late presenting cases (84.1% versus 46.2%, p = 0.009). Conclusions: Intestinal erosion from prosthetic material is a rare complication of hernia repair leading to considerable morbidity. Prompt operative repair is key in avoiding catastrophic consequences. © 2020, Springer-Verlag France SAS, part of Springer Nature." }