Preventing parastomal hernia with a prosthetic mesh.
OBJECTIVE
Parastomal hernia is a common complication following colostomy. The lowest recurrence rate has been produced when repair is with a prosthetic mesh. This study evaluated the effect on stoma complications of using a mesh during the primary operation.


METHODS
Randomized clinical study.


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


RESULTS
Twenty-seven patients had a conventional stoma, and in 27 patients the mesh was used. No infection, fistula formation, or pain occurred (observation time, 12-38 months). At the 12-month follow-up, parastomal hernia was present in 13 of 26 patients without a mesh and in 1 of 21 patients in whom the mesh was used.


CONCLUSIONS
A lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material placed in a sublay position at the stoma site is not associated with complications and significantly reduces the rate of parastomal hernia.
Jänes
Arthur
A
Kirurgkliniken, Sundsvalls sjukhus, SE-851 86 Sundsvall, Sweden. arthur.janes@lvn.se
Cengiz
Yucel
Y
Israelsson
Leif A
LA
D000368:Aged; D003125:Colostomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D013526:Surgical Mesh