Is There Indication for the Use of Biological Mesh in Cancer Patients?

Abstract

Up to 28% of all patients who undergo open surgery will develop a ventral hernia (VH) in the post-operative period. VH surgery is a debated topic in the literature, especially in oncological patients due to complex management. We searched in the surgical database of the Hepatobiliary Unit of the National Cancer Institute of Naples “G. Pascale Foundation” for all patients who underwent abdominal surgery for malignancy from January 2010 to December 2018. Our surgical approach and our choice of mesh for VH repair was planned case-by-case. We selected 57 patients that fulfilled our inclusion criteria, and we divided them into two groups: biological versus synthetic prosthesis. Anterior component separation was used in 31 patients (54.4%) vs. bridging procedure in 26 (45.6%). In 41 cases (71.9%), we used a biological mesh while a synthetic one was adopted in the remaining patients. Of our patients, 57% were male (33 male vs. 24 female) with a median age of 65 and a mean BMI of 30.8. We collected ventral hernia defects from 35 cm2 to 600 cm2 (mean 205.2 cm2); 30-day complications were present in 24 patients (42.1%), no 30-day mortality was reported, and 21 patients had a recurrence of pathology during study follow-up. This study confirms VH recurrence risk is not related with the type of mesh but is strongly related with BMI and type of surgery also in oncological patients.

A Review of Abdominal Meshes for Hernia Repair—Current Status and Emerging Solutions

“…Hernia repair is favored by interdisciplinary technological advances, as its performant management benefits from developments in bioprosthetic devices, materials, surgical techniques, and combined approaches [24]. Concerning mesh options, a wide range of biomedical textiles are clinically available, each with advantages and disadvantages depending on placement position and usage circumstances [9].…”

Novel Material Optimization Strategies for Developing Upgraded Abdominal Meshes

“…The advances in the interconnected fields of health services, medical technology, and material sciences have led to the fabrication of numerous hernia repair meshes. Products made of different polymers with varied physicochemical properties ( Figure 1 ) are currently available on the market for surgeons to choose from when bridging defects or reinforcing the abdominal wall [ 1 , 8 , 9 , 10 ].…”