Comparison of clinical outcomes between synthetic mesh abdominal wall reconstruction patients with or without bowel resection

Abstract

BACKGROUND: Concurrent prosthetic mesh abdominal wall reconstruction during bowel resection remains controversial due to concerns over contamination risks. This study evaluates the safety and efficacy of single-stage mesh repair in bowel resection and compares outcomes between resection and non-resection cohorts. This study evaluates the safety and efficacy of single-stage mesh repair in bowel resection and compares outcomes between resection and non-resection cohorts.

MATERIALS AND METHODS: A retrospective analysis included 79 patients undergoing abdominal wall reconstruction (2018-2023), stratified into bowel resection (n = 22) and non-resection (n = 57) groups. Surgical techniques included open sublay and laparoscopic laparoscopic intraperitoneal onlay mesh plus mesh implantation. Outcomes assessed complication rates, recurrence, and quality of life through Carolinas comfort scale (CCS). Statistical analysis utilized Statistical Package for the Social Sciences 26.0 with P < 0.05 as significance threshold.

RESULTS: Operative time and hospitalization were longer in the bowel resection group (P < 0.05). No significant differences were observed in overall complication rates (36.36% vs. 36.84%, P > 0.05), including mesh infection (4.55% vs. 7.02%), and recurrence (9.09% vs. 8.77%). CCS scores indicated comparable quality of life, with 77.27% of resection and 71.93% of non-resection patients reporting minimal discomfort (scores ≤10).

CONCLUSIONS: Single-stage mesh repair with bowel resection demonstrates safety and efficacy equivalent to non-resection procedures under rigorous infection control. The findings challenge traditional multi-stage approaches, supporting individualized decisions based on contamination severity and patient factors.

Keywords

Abdominal surgery / abdominal wall hernia / bowel resection / Carolinas Comfort Scale / prosthetic mesh repair / single-stage reconstruction

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International Journal of Abdominal Wall and Hernia Surgery | Published by Wolters Kluwer - Medknow on behalf of Higher Education Press