Laparoscopic stoma formation with a prophylactic prosthetic mesh.
BACKGROUND
One year after stoma formation with an open technique, the rate of parastomal hernia is almost 50%. The herniation rate can be reduced to 10% with the use of a prophylactic mesh in a sublay position. For stomas formed with a laparoscopic technique, a surgical method with the use of prophylactic mesh should be sought.


METHODS
Patients with a sigmoidostomy created with a laparoscopic technique were provided with a prophylactic large-pore, low-weight mesh in a sublay position. Follow-up examination was carried out after at least 12 months.


RESULTS
Between March 2003 and May 2007, a sigmoidostomy was created in 25 patients. The patients' mean age was 65 years (range 31-89), the mean body mass index was 26 (range 21-32) and 15 were female. One stoma necrosis and two minor wound infections occurred. Parastomal hernia was present in 3 of 20 patients (15%) available for follow-up examination after 11-31 months (mean 19). No fistulas or strictures had developed. No mesh infection was noted and no mesh was removed.


CONCLUSIONS
In laparoscopic stoma formation, a prophylactic large-pore, low-weight mesh in a sublay position is an easy and safe procedure associated with a low rate of parastomal hernia.
Janson
A R
AR
Department of Surgery, Kirurgkliniken, Sundsvalls sjukhus, Sundsvall, Sweden. alfred.janson@lvn.se
Jänes
A
A
Israelsson
L A
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004766:Enterostomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects*; D054047:Surgical Stomas / Q000009:adverse effects*