Outcomes of abdominal reconstruction with biological versus synthetic mesh in complex resection surgeries for retroperitoneal tumors
DOI:
https://doi.org/10.51798/sijis.v6i4.1069Keywords:
Abdominal wall reconstruction, synthetic mesh, biologic mesh, retroperitoneal tumors, hernia recurrence, oncologic surgeryAbstract
Background: Complex abdominal wall reconstruction (AWR) is frequently required during retroperitoneal tumor (RPT) resections, often in contaminated fields. Biologic and synthetic mesh selection is consequential, and discussion of their long-term functional outcomes and postoperative complication profiles continues. Methods: The current systematic review that follows PRISMA guidelines conducted a search in PubMed, Embase, Scopus, and Cochrane CENTRAL until May 2025. The inclusion criteria included randomised controlled trials (RCTs), well-conducted observational studies and meta-analyses of biologic and synthetic mesh used in complex or contaminated AWR surgery, and post-oncologic resections. Outcomes were examined, including recurrence of hernia, surgical site infection (SSI), infection of the mesh, rates of reoperation, abdominal fitness recovery, and cost. Results: In results, synthetic mesh showed significantly lower hernia recurrence (5.6–24%) compared to biologic mesh (20.5–39.7%) across multiple trials (e.g., Rosen et al.: HR 0.31, P < 0.001). Infection and complication rates were statistically comparable. Functional recovery and abdominal wall strength were superior with synthetic mesh, particularly in retromuscular placements. Biologic meshes incurred significantly higher costs (up to $27,000 more per case). Observational data in oncologic settings confirmed these trends. Conclusion: After our research, we can conclude that synthetic mesh offers superior recurrence prevention, functional recovery, and cost-effectiveness without increasing complications while supporting its preferential use over biologic mesh in complex AWR following retroperitoneal tumor resections.
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Copyright (c) 2025 Katherine Solange Beltrán Parreño, Alexis Quetzalcóatl Vega Morales, Jose Roberto Gonzalez Soto, Juan Felipe Lozano Rodríguez, Yemdiel Zecua Mellado
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