Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia.
BACKGROUND
Parastomal hernia is a common complication following colostomy, and repair with a prosthetic mesh is associated with the lowest recurrence rate. The aim of this study was to determine the effect on stoma complications of using a mesh at the primary operation.


METHODS
Patients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. A large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used.


RESULTS
Twenty-seven patients were randomized to have a conventional stoma and 27 to have the mesh. No infection, fistula formation or pain occurred (observation time 2-28 months). At the 12-month follow-up, parastomal hernia was present in eight of 18 patients without a mesh and in none of 16 patients in whom the mesh was used.


CONCLUSIONS
A lightweight prosthetic mesh in a sublay position at the stoma site was not associated with infection or other early complications. Preliminary results indicate that the mesh prevented the development of parastomal hernia.
Jänes
A
A
Department of Surgery, Sundsvalls sjukhus, Sundsvall, Sweden. Artur.Janes@lvn.se
Cengiz
Y
Y
Israelsson
L A
LA
D000368:Aged; D003125:Colostomy; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000517:prevention & control*; D006801:Humans; D008297:Male; D011126:Polypropylenes / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000209:etiology
D011126:Polypropylenes