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OUTCOMES OF VENTRAL HERNIA REPAIR WITH INTRAPERITONEAL MESH IN PATIENTS WITH CROHN'S DISEASE
Kara Donovan^*, Merritt Denham, Michelle Leong, Kristine Kuchta, JoAnn Carbray, Woody Denham, Stephen P. Haggerty, John G. Linn, Michael Ujiki
NorthShore University Health System, Evanston, IL
Introduction: Currently, there is controversy over whether intraperitoneal mesh placement during ventral hernia repair (VHR) is appropriate for patients with Crohn's Disease (CD). Our study aims to evaluate feasibility, safety, and efficacy of intraperitoneal mesh placement in CD patients.

Methods: Consecutive patients undergoing VHR with intraperitoneal mesh at a single institution from 2009-2017 were identified from a prospectively managed quality database. Two groups, CD and no CD, were identified and compared. An initial analysis revealed significant differences in the demographics and hernia characteristics, such as hernia type, hernia size, and mesh size between the two groups. To control for these differences, a 1:1 propensity score matching method was conducted. The groups were matched for hernia size, mesh size, and presence of a parastomal hernia. A Kaplan-Meier survival analysis was used to analyze the time to recurrence between groups.

Results: 2,281 patients were identified that underwent ventral hernia repair. Of these, 372 patients had adequate follow-up for comparison. Of these, 31 patients had CD. The overall rate of recurrence for the 341 patients with no CD was 4.1%. Rates of recurrence between the matched CD group and non-CD group (29.0% vs. 22.6%) were not significantly different (p=0.5616). Rates of reoperation (12.9% vs. 6.4%; p=0.6713) and readmission (16.1% vs.12.9%; p=0.7635) were not significantly different. Rates of mesh infection were also not different (6.4% vs. 9.7%; p=0.6409). Age, BMI, hernia type, and mesh used were similar between groups. Recurrence-free survival was not significantly different (p=0.4354), indicating no difference in time to recurrence between the two groups.

Conclusion: Our retrospective review of VHR patients with intraperitoneal mesh placement found no difference in recurrence or reoperation rate between patients with CD and those without, suggesting intraperitoneal mesh is effective for both groups. Furthermore, with no difference in mesh infection rates between groups, these results suggest intraperitoneal mesh can safely be used in VHR for patients with CD.

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