Fadaee Negin, Huynh Desmond, Khanmohammed Zayan, Mazer Laura, Capati Isabel, Towfigh Shirin
California Health Sciences University College of Osteopathic Medicine, Clovis, CA, United States.
Cedars-Sinai Medical Center, Los Angeles, CA, United States.
J Abdom Wall Surg. 2023 Jan 30;2:10983. doi: 10.3389/jaws.2023.10983. eCollection 2023.
In our practice, we have noticed an increased number of patients requiring mesh removal due to a systemic reaction to their implant. We present our experience in diagnosing and treating a subpopulation of patients who require mesh removal due to a possible mesh implant illness (MII). All patients who underwent mesh removal for indication of mesh reaction were captured from a hernia database. Data extraction focused on the patients' predisposing medical conditions, presenting symptoms suggestive of mesh implant illness, types of implants to which reaction occurred, and postoperative outcome after mesh removal. Over almost 7 years, 165 patients had mesh removed. Indication for mesh removal was probable MII in 28 (17%). Most were in females (60%), average age was 46 years, with average pre-operative pain score 5.4/10. All patients underwent complete mesh removal. Sixteen (57%) required tissue repair of their hernia; 4 (14%) had hybrid mesh implanted. Nineteen (68%) had improvement and/or resolution of their MII symptoms within the first month after removal. We present insight into a unique but rising incidence of patients who suffer from systemic reaction following mesh implantation. Predisposing factors include female sex, history of autoimmune disorder, and multiple medical and environmental allergies and sensitivities. Presenting symptoms included spontaneous rashes, erythema and edema over the area of implant, arthralgia, headaches, and chronic fatigue. Long-term follow up after mesh removal confirmed resolution of symptoms after mesh removal. We hope this provides greater attention to patients who present with vague, non-specific but debilitating symptoms after mesh implantation.
在我们的临床实践中，我们注意到因对植入物产生全身反应而需要取出补片的患者数量有所增加。我们介绍了对因可能的补片植入病（MII）而需要取出补片的一部分患者进行诊断和治疗的经验。所有因补片反应而接受补片取出手术的患者均从疝病数据库中获取。数据提取重点关注患者的易感疾病状况、提示补片植入病的症状、发生反应的植入物类型以及补片取出后的术后结果。在近7年的时间里，有165例患者取出了补片。因可能的MII而取出补片的有28例（17%）。大多数为女性（60%），平均年龄46岁，术前平均疼痛评分为5.4/10。所有患者均接受了完整的补片取出。16例（57%）需要对疝进行组织修复；4例（14%）植入了复合补片。19例（68%）在取出补片后的第一个月内MII症状得到改善和/或缓解。我们深入探讨了补片植入后出现全身反应的患者这一独特但不断上升的发病率。易感因素包括女性、自身免疫性疾病史以及多种药物和环境过敏及敏感。出现的症状包括自发性皮疹、植入区域的红斑和水肿、关节痛、头痛以及慢性疲劳。补片取出后的长期随访证实取出补片后症状得到缓解。我们希望这能让人们更加关注补片植入后出现模糊、非特异性但使人衰弱症状的患者。
