TREATMENT OF POSTOPERATIVE ABDOMINAL EVEN TRATIONS WITH A NONRESORBABLE PROSTHESIS - A SERIES OF 160 CASES

We reviewed retrospectively a series of eventrations treated with a no nresorbable prosthesis. Most of the eventrations occurred after medial laparotomies (83.7 %), predominantly with sub-umbilical incision (42. 5 %) and often after gynecological or biliary surgery (31.9 and 27.5 % respectively). Predisposing factors were obesity (38.1 %) and post-op erative infection of the suture (21 %). Delay to eventration was 5.5 y ears (range 1 to 30 years). In 17 % of the cases recurrent eventration was seen after one or more cures (maximum of 5). The prosthesis was a lways positioned behind the muscle, either ventrally to the posterior sheath of the rectus abdominis or directly in a properitoneal position . Resorbable U sutures (41.2 %) or stapling were used. There was one p ost-operative death due to massive pulmonary embolism on day 10. Morbi dity was 8.1 % (4 respiratory complications, 4 pulmonary embolisms, 1 intestinal occlusion due to loop agglutination, 9 hematomas including 6 requiring reoperation). There were also 11 cases of infection of the suture with 3 involving the prosthesis. Long-term follow-up of 149 pa tients (93.1 %) revealed on death related to former repair. There were 13 deaths related to intercurrent disease unrelated to the technique. Recurrence was observed in 10 patients including 4 who were reoperate d for positioning a complementary prosthesis. There was one case of cu taneous fistula and one case involving an aseptic collection in contac t with the prosthesis.