[Failure of the treatment of eventrations and hernias with the PTFE plate (111 cases)]

Patch repair using a PTFE prosthesis was performed in 111 patients over a 5-year period for treatment of incisional hernias (64 cases), inguinal hernias (41 cases, including 29 recurrences), umbilical hernias (4 cases), epigastric hernias (2 cases), lumbar hernias (1 case) and abdominal wall defects after resection for endometriosis (2 cases). The surgical technique was limited to simple patch closure of peritoneomuscular defects without myoplasty. Follow-up was evaluable for every patient and 84 cases have been reviewed clinically by 2 surgeons. 83 patients (86 patches) were followed for at least 1 year (74.8%). Post operative mortality was nil. Morbidity was 17.5% (20 cases, including 14 hematomas, 2 intraperitoneal bleedings, 3 cases of local sepsis, 1 hydrocele). Recurrence rate was 42.2% for incisional hernia repair (27 cases) and 14.6% after inguinal hernia repair. Three out of 4 umbilical hernias and 1 out of 2 epigastric hernias recurred. 14 patients underwent reoperation for recurrent hernia (11 incisional and 3 inguinal). Absence of fibrotic reaction around the PTFE prosthesis was noted in every case and appeared to be the main factor of recurrence. Our experience suggests that patch technique with PTFE prosthesis should be abandoned for the repair of abdominal wall defects.