TY - JOUR
TI - Intestinal erosions following inguinal hernia repair: a systematic review
AU - Koliakos, N.
AU - Papaconstantinou, D.
AU - Nastos, C.
AU - Kirkilesis, G.
AU - Bompetsi, G.
AU - Bakopoulos, A.
AU - Ntomi, V.
AU - Pikoulis, E.
JO - Revista Hispanoamericana de Hernia
PY - 2021
VL - 25
TODO - 5
SP - 1137-1145
PB - Springer-Verlag Italia s.r.l.
SN - 2255-2677
TODO - 10.1007/s10029-020-02324-1
TODO - 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
TODO - 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.
ER -