title: A new stomaplasty ring (Koring™) to prevent parastomal hernia: an observational multicenter Swiss study.
abstract: BACKGROUND
  Parastomal hernias (PSH) are one of the most frequent complications of enterostomies with a non-negligible complication rate and a significant socioeconomic effect. Therefore, preventing PSH by placing a mesh at the time of primary surgery has been advocated. The aim of our study was to evaluate the safety and feasibility of the new stomaplasty ring [Koring™, (Koring GmbH, Basel, Switzerland)] and investigate the reason why surgeons are reluctant to take preventive measures.
  
  
  METHODS
  A multicenter observational study was conducted on 30 patients between December 2013 and January 2015. In permanent end colostomies and end ileostomies, the Koring™ was implanted. The primary outcome was the 30-day morbidity (infection and other stoma-related complications). Secondary endpoints were the technical feasibility and the time needed to fix the ring. In addition, an online survey of 107 surgeons was performed.
  
  
  RESULTS
  Twenty-seven patients received permanent end colostomies, and three received end ileostomies. No stoma-related complication was detected within the first 30 days post-operatively. The Koring™ ring was evaluated by the surgeons as easy and very easy to implant in more than half of the patients. Average additional operating time for ring implantation was 19 min.
  
  
  CONCLUSIONS
  Koring™ implantation at the time of creating the stoma is safe, easy and only adds minimally operating time. A long-term follow-up as well as a randomized controlled study is needed to evaluate the impact of the Koring™ on PSH prevention. The ease and rapidity with which Koring™ can be implanted may help surgeons to overcome their apprehension of using a preventative device.
authors.affiliation: Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: V
authors.initials: V
authors.lastname: Guarnero
authors.affiliation: Department of Visceral Surgery, University Hospital of Basel, Basel, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Hoffmann
authors.affiliation: Department of Surgery, Cantonal Hospital of Schaffhausen, Schaffhausen, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Hetzer
authors.affiliation: Department of Visceral Surgery, University Hospital of Basel, Basel, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Oertli
authors.affiliation: Department of Visceral and Transplantation Surgery, University Hospital of Zürich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Turina
authors.affiliation: Department of Surgery, Hospital of Limmattal, Schlieren, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Zingg
authors.affiliation: Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Demartines
authors.affiliation: Department of Visceral Surgery, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Ris
authors.affiliation: Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland. dieter.hahnloser@chuv.ch.
authors.forename: D
authors.initials: D
authors.lastname: Hahnloser
mesh_terms: D000368:Aged; D003125:Colostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004766:Enterostomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D019736:Prostheses and Implants; D054047:Surgical Stomas / Q000009:adverse effects*; D013557:Switzerland
keywords: Parastomal hernia; Prevention; Ring; Stomaplasty