World Journal of Surgery

, Volume 34, Issue 7, pp 1637–1640 | Cite as

Experiences with a Prophylactic Mesh in 93 Consecutive Ostomies

  • Arthur Jänes
  • Yucel Cengiz
  • Leif A. Israelsson



Parastomal hernia may be present in half of patients after one year. A prophylactic low-weight prosthetic mesh in a sublay position at the index operation reduces the risk of parastomal hernia, without increasing the rate of complications.


Between April 2003 and November 2006 all patients with an ostomy created at an open laparotomy were followed for at least one year.


A prophylactic mesh was used in 75 of 93 patients. In 9 a prophylactic mesh could not be placed due to scarring after previous surgery. In 9 a mesh was omitted after surgeon’s decision. In 19 patients a mesh was used in severely contaminated wounds. With a mesh 6 of 73 (8%) patients developed a surgical site infection and without a mesh 4 of 15 (27%). With a mesh parastomal hernia was present in 8 of 61 (13%) patients and without a mesh in 8 of 12 (67%).


Creating a stoma in routine open surgery a prophylactic mesh can be placed in most patients. A mesh does not increase the rate of complications and can be used in severely contaminated wounds.


Parastomal Hernia Open Laparotomy Bowel Continuity Posterior Rectus Sheath Fecal Content 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Birnbaum W, Ferrier P (1952) Complications of abdominal colostomy. Am J Surg 83:64–67CrossRefPubMedGoogle Scholar
  2. 2.
    Burns FJ (1970) Complications of colostomy. Dis Colon Rectum 13:448–450CrossRefPubMedGoogle Scholar
  3. 3.
    Abrams BL, Alsikafi FH, Waterman NG (1979) Colostomy: a new look at morbidity and mortality. Am Surg 45:462–464PubMedGoogle Scholar
  4. 4.
    Sjodahl R, Anderberg B, Bolin T (1988) Parastomal hernia in relation to site of the abdominal stoma. Br J Surg 75:339–341CrossRefPubMedGoogle Scholar
  5. 5.
    Pearl RK (1989) Parastomal hernias. World J Surg 13:569–572CrossRefPubMedGoogle Scholar
  6. 6.
    Londono-Schimmer EE, Leong AP, Phillips RK (1994) Life table analysis of stomal complications following colostomy. Dis Colon Rectum 37:916–920CrossRefPubMedGoogle Scholar
  7. 7.
    Cheung MT (1995) Complications of an abdominal stoma: an analysis of 322 stomas. Aust N Z J Surg 65:808–811CrossRefPubMedGoogle Scholar
  8. 8.
    Makela JT, Turko PH, Laitenen ST (1997) Analysis of late stomal complications following ostomy surgery. Ann Chir Gynaecol 86:305–310PubMedGoogle Scholar
  9. 9.
    Carne PW, Robertson GM, Frizelle FA (2003) Parastomal hernia. Br J Surg 90:784–793CrossRefPubMedGoogle Scholar
  10. 10.
    Israelsson LA (2005) Preventing and treating parastomal hernia. World J Surg 29:1086–1089CrossRefPubMedGoogle Scholar
  11. 11.
    Israelsson LA (2008) Parastomal hernias. Surg Clin North Am 88:113–125CrossRefPubMedGoogle Scholar
  12. 12.
    Janes A, Cengiz Y, Israelsson LA (2004) Preventing parastomal hernia with a prosthetic mesh. Arch Surg 139:1356–1358CrossRefPubMedGoogle Scholar
  13. 13.
    Janes A, Cengiz Y, Israelsson LA (2004) Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia. Br J Surg 91:280–282CrossRefPubMedGoogle Scholar
  14. 14.
    Robertson I, Leung E, Hughes D et al (2005) Prospective analysis of stoma-related complications. Colorectal Dis 7:279–285CrossRefPubMedGoogle Scholar
  15. 15.
    Murrell ZA, Dixon MR, Vargas H et al (2005) Contemporary indications for and early outcomes of abdominoperineal resection. Am Surg 71:837–840PubMedGoogle Scholar
  16. 16.
    Cingi A, Cakir T, Sever A et al (2006) Enterostomy site hernias: a clinical and computerized tomographic evaluation. Dis Colon Rectum 49:1559–1563CrossRefPubMedGoogle Scholar
  17. 17.
    Gogenur I, Mortensen J, Harvald T et al (2006) Prevention of parastomal hernia by placement of a polypropylene mesh at the primary operation. Dis Colon Rectum 49:1131–1135CrossRefPubMedGoogle Scholar
  18. 18.
    Kouba E, Sands M, Lentz A et al (2007) Incidence and risk factors of stomal complications in patients undergoing cystectomy with ileal conduit urinary diversion for bladder cancer. J Urol 178:950–954CrossRefPubMedGoogle Scholar
  19. 19.
    Cingi A, Solmaz A, Attaallah W et al (2008) Enterostomy closure site hernias: a clinical and ultrasonographic evaluation. Hernia 12:401–405CrossRefPubMedGoogle Scholar
  20. 20.
    Moreno-Matias J, Serra-Aracil X, Darnell-Martin A et al (2009) The prevalence of parastomal hernia after formation of an end colostomy. A new clinico-radiological classification. Colorectal Dis 11:173–177CrossRefPubMedGoogle Scholar
  21. 21.
    Kald A, Juul KN, Hjortsvang H et al (2008) Quality of life is impaired in patients with peristomal bulging of a sigmoid colostomy. Scand J Gastroenterol 43:627–633CrossRefPubMedGoogle Scholar
  22. 22.
    Janes A, Cengiz Y, Israelsson LA (2009) Preventing parastomal hernia with a prosthetic mesh: a 5-year follow-up of a randomized study. World J Surg 33:118–121CrossRefPubMedGoogle Scholar
  23. 23.
    De Raet J, Delvaux G, Haentjens P et al (2008) Waist circumference is an independent risk factor for the development of parastomal hernia after permanent colostomy. Dis Colon Rectum 51:1806–1809CrossRefPubMedGoogle Scholar
  24. 24.
    Marimuthu K, Vijayasekar C, Ghosh D et al (2006) Prevention of parastomal hernia using preperitoneal mesh: a prospective observational study. Colorectal Dis 8:672–675CrossRefPubMedGoogle Scholar
  25. 25.
    Berger D (2008) Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST). Hernia 12:243–246CrossRefPubMedGoogle Scholar
  26. 26.
    Helgstrand F, Gogenur I, Rosenberg J (2008) Prevention of parastomal hernia by the placement of a mesh at the primary operation. Hernia 12:577–582CrossRefPubMedGoogle Scholar
  27. 27.
    Hammond TM, Huang A, Prosser K et al (2008) Parastomal hernia prevention using a novel collagen implant: a randomised controlled phase 1 study. Hernia 12:475–481CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Arthur Jänes
    • 1
  • Yucel Cengiz
    • 1
  • Leif A. Israelsson
    • 2
  1. 1.Department of SurgerySundsvalls sjukhusSundsvallSweden
  2. 2.Department of Surgery and Perioperative ScienceUmeå UniversityUmeåSweden

Personalised recommendations