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.
Department of Surgery, Sundsvalls sjukhus, Sundsvall, Sweden. Artur.Janes@lvn.se
A
A
Jänes
Y
Y
Cengiz
L A
LA
Israelsson
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