International Journal of Colorectal Disease

, Volume 30, Issue 9, pp 1217–1222 | Cite as

Prophylactic stoma mesh did not prevent parastomal hernias

  • Maziar Nikberg
  • Ingvar Sverrisson
  • Konstantinos Tsimogiannis
  • Abbas Chabok
  • Kenneth Smedh
Original Article

Abstract

Purpose

Parastomal herniation is reported in up to 50 % of patients with a colostomy. A prophylactic stoma mesh has been reported to reduce parastomal hernia rates. The aim of the study was to evaluate the rate of parastomal hernias in a population-based cohort of patients, operated with and without a prophylactic mesh at two different time periods.

Methods

All rectal cancer patients operated with an abdominoperineal excision or Hartmann’s procedure between 1996 and 2012 were included. From 2007, a prophylactic stoma mesh was placed in the retro-muscular plane. Patients were followed prospectively with clinical and computed tomography examinations.

Results

There were no differences with regard to age, gender, pre-operative albumin levels, ASA score, body mass index (BMI), smoking or type of surgical resection between patients with (n = 71) and without a stoma mesh (n = 135). After a minimum follow-up of 1 year, 187 (91 %) of the patients were alive and available for analysis. At clinical and computed tomography examinations, exactly the same parastomal hernia rates were found in the two groups, viz, 25 and 53 %, respectively (p = 0.95 and p = 0.18). The hernia sac contained omentum or intestinal loops in 26 (81 %) versus 26 (60 %) patients with and without a mesh, respectively (p = 0.155). In the multivariate analyses, high BMI was associated with parastomal hernia formation.

Conclusions

A prophylactic stoma mesh did not reduce the rate of clinically or computed tomography-verified parastomal hernias. High BMI was associated with an increased risk of parastomal hernia formation regardless of prophylactic stoma mesh.

Keywords

Parastomal hernia Mesh Surgery Rectal cancer Colostomy 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Maziar Nikberg
    • 1
    • 2
  • Ingvar Sverrisson
    • 1
    • 2
  • Konstantinos Tsimogiannis
    • 1
  • Abbas Chabok
    • 1
    • 2
  • Kenneth Smedh
    • 1
    • 2
  1. 1.Department of SurgeryVästmanland’s Hospital VästeråsVästeråsSweden
  2. 2.Västmanland’s Hospital VästeråsCentre for Clinical Research of Uppsala UniversityVästeråsSweden

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