PC13. Abdominal Wall Reconstruction in Patients with Inflammatory Bowel Disease: A Single Center Experience

PURPOSE: Patients with inflammatory bowel disease (IBD) are at increased risk for postoperative complications due to prior surgical history, poor nutritional status, and immunomodulation. We investigate surgical outcomes after abdominal wall reconstruction (AWR) in patients with IBD. METHODS: A single-institution, retrospective review was performed of all patients with IBD undergoing abdominal wall reconstruction from 2016 to 2022. RESULTS: Fifty-eight patients were included, with 31 patients with Crohn’s disease and 27 patients with ulcerative colitis. The average age was 52.3 (±14.5) years and average BMI was 26.7 (±4.5) at time of surgery. Seventeen (29.3%) patients were on a steroid or immunomodulator prior to surgery. Patients had an average of 3.1 (±1.8) prior abdominal surgeries; 14 (24.1%) patients had prior hernia repair. The hernia breakdown was commonly midline 38 (65.5%) and parastomal 9 (15.5%). Biologic mesh was used in 7 (12.1%) cases. Postoperatively, 7 (12.1%) patients experienced major complications; 6 patients required takeback for abscess drainage (3), small bowel obstruction/perforation (2), or ileostomy revision (1), and 1 patient had sepsis and liver failure requiring prolonged care. Minor complications were seen in 19 (32.8%) patients, consisting of ileus or high ostomy output (13), superficial surgical site infection (3), and incisional breakdown or dehiscence (3). Patients were followed for an average of 314 (± 310.6) days. There were no instances of abdominal bulge and 1 patient with hernia recurrence. CONCLUSION: AWR in the IBD patient population can be performed with low complication rates. Most AWR were performed without mesh without compromising hernia recurrence rates.