Mesh-related complications and recurrence after incisional hernia repair in patients with fistulizing versus non-fistulizing Crohn’s disease
- 01.12.2025
- Original Article
Erschienen in:
- Verfasst von
- Hans Lovén
- Rune Erichsen
- Anders Tøttrup
- Thue Bisgaard
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
Patients with Crohn’s disease (CD) frequently undergo multiple abdominal operations, which increase the risk of incisional hernia repair (IHR) and associated mesh-related complications. Patients with intra-abdominal fistulizing CD (FCD) may be more susceptible to mesh-related complications than patients with non-fistulizing CD (non-FCD). The primary objective was to evaluate the risk of reoperation due to mesh-related complications after IHR in patients with FCD and non-FCD. Secondarily, the study evaluated the impact of isolated perianal fistulizing CD on mesh-related complications and the difference in hernia recurrence reoperation rates between FCD and non-FCD patients.
Methods
This nationwide study followed patients from 30 days after their first recorded IHR until reoperation due to mesh-related complications or hernia recurrence. Cumulative incidence proportion and Cox regression analysis were used to estimate the risk of these outcomes.
Results
A total of 334 patients with CD (FCD, n = 55; non-FCD, n = 279) underwent IHR between 2007 and 2016 with a follow-up rate of 100%. FCD patients had a significantly higher 5 year risk of reoperation for mesh-related complications (HR 15.95, 95% CI 4.29–59.35) compared with non-FCD patients. None of the patients with isolated perianal fistulizing disease required a reoperation for mesh-related complications. The overall risk of reoperation for recurrence was 8.7%, and did not vary significantly between FCD and non-FCD patients (HR 1.06, 95% CI 0.44–2.58).
Conclusions
FCD may be associated with higher rates of mesh-related complications compared with non-FCD, although larger studies are needed to confirm this finding. Conversely, isolated perianal fistulas do not appear to be associated with an increased risk of mesh-related complications. The benefits associated with mesh should be balanced with the risk of long-term mesh-related complications in patients with FCD.
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- Titel
- Mesh-related complications and recurrence after incisional hernia repair in patients with fistulizing versus non-fistulizing Crohn’s disease
- Verfasst von
-
Hans Lovén
Rune Erichsen
Anders Tøttrup
Thue Bisgaard
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03228-0
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