Title: Biosynthetic Versus Synthetic Mesh in Oncologic Ventral Hernia Repair
Background:
•Ventral hernia repair in oncologic patients is challenging due to poor tissue quality, immunosuppression, malnutrition, and prior operations.
•Synthetic and biologic meshes offer advantages and disadvantages, including strength and resistance to contamination
•Biosynthetic mesh material, such as that composed of poly-4-hydroxybutyrate (P4HB), represents an alternative to standard allo- and xenograft implants, and are designed to combine synthetic materials' durability with biologics' biocompatibility
•There is a lack of comparative studies directly evaluating outcomes of biosynthetic vs. synthetic meshes in cancer patients
Objectives:
Compare hernia recurrence and surgical risk factors in oncologic patients undergoing hernia repair with either biosynthetic or synthetic mesh reinforcement following prior abdominal or pelvic oncologic resection
Methods:
Study population:
Patients > ≥ 18 years of age
Retrospective review, 2010-2023
Inclusion:
Prior history of abdominal or pelvic oncologic resection, which was complicated by hernia development and subsequently underwent repair with either biosynthetic or synthetic mesh
Conclusion;
•Biosynthetic & Synthetic mesh are both effective options for ventral hernia repair in oncologic patients
•Retrorectus mesh placement and bilateral component separation are critical in reducing hernia recurrence risk in oncologic hernia repair
•Radiation increases the risk of hernia recurrence following repair
References:
1.Rosen MJ, Krpata DM, Petro CC, et al. Biologic vs synthetic mesh for single-stage repair of contaminated ventral hernias: a randomized clinical trial. JAMA surgery. 2022;157(4):293-301.
2.Harris HW, Primus F, Young C, et al. Preventing recurrence in clean and contaminated hernias using biologic versus synthetic mesh in ventral hernia repair: the PRICE randomized clinical trial. LWW; 2021.
3.Burger JWA, Luijendijk RW, Hop WCJ, Halm JA, Verdaasdonk EGG, Jeekel J. Long-term Follow-up of a Randomized Controlled Trial of Suture Versus Mesh Repair of Incisional Hernia. Annals of Surgery. 2004;240(4):578-585. doi:10.1097/01.sla.0000141193.08524.e7
4.Song Y, Shannon AB, Roses RE, Fraker DL, Kelz RR, Karakousis GC. National trends in ventral hernia repairs for patients with intra-abdominal metastases. Surgery. Sep 2020;168(3):509-517. doi:10.1016/j.surg.2020.04.005
