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Preventing Parastomal Hernia with a Prosthetic Mesh: A 5-Year Follow-up of a Randomized Study

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Abstract

Background

Parastomal hernia is a major clinical problem. In a randomized, clinical trial, a prosthetic mesh in a sublay position at the index operation reduced the rate of parastomal hernia at 12-month follow-up, without any increase in the rate of complications. This study was designed to evaluate the rate of complications after 5 years.

Methods

Between January 2001 and April 2003, 54 patients who had a permanent ostomy were randomized to a conventional stoma or to a stoma with the addition of a mesh in a sublay position. A large-pore, lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used.

Results

After 5 years, 21 patients with a conventional stoma were alive and parastomal herniation was recorded in 17 patients, of whom repair had been demanded in 5. In 15 patients operated on with the addition of a mesh herniation, that did not require repair, was present in 2 (P < 0.001). No fistulas or strictures developed. No mesh infection was noted and no mesh was removed during the study period.

Conclusions

At stoma formation, a prophylactic low-weight mesh in a sublay position is a safe procedure that reduces the rate of parastomal hernia.

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References

  1. Pearl RK (1989) Parastomal hernias. World J Surg 13:569–572

    Article  PubMed  CAS  Google Scholar 

  2. Birnbaum W, Ferrier P (1952) Complications of abdominal colostomy. Am J Surg 3:64–67

    Article  Google Scholar 

  3. Burns FJ (1970) Complications of colostomy. Dis Colon Rectum 13:448–450

    Article  PubMed  CAS  Google Scholar 

  4. Abrams BL, Alsikafi FH, Waterman NG (1979) Colostomy: a new look at morbidity and mortality. Am Surg 45:462–464

    PubMed  CAS  Google Scholar 

  5. Burgess P, Matthew VV, Devlin HB (1984) A review of terminal colostomy complications following abdominoperineal resection for carcinoma. Br J Surg 71:1004

    Google Scholar 

  6. Cevese PG, D’Amico DF, Biasiato R et al (1984) Peristomal hernia following end-colostomy: a conservative approach. Ital J Surg Sci 14:207–209

    PubMed  CAS  Google Scholar 

  7. Cheung MT (1995) Complications of an abdominal stoma: an analysis of 322 stomas. Aust N Z J Surg 65:808–811

    Article  PubMed  CAS  Google Scholar 

  8. Londono-Schimmer EE, Leong AP, Phillips RK (1994) Life table analysis of stomal complications following colostomy. Dis Colon Rectum 37:916–920

    Article  PubMed  CAS  Google Scholar 

  9. Ortiz H, Sara MJ, Armendariz P et al (1994) Does the frequency of paracolostomy hernias depend on the position of the colostomy in the abdominal wall? Int J Colorectal Dis 9:65–67

    Article  PubMed  CAS  Google Scholar 

  10. Pearl RK, Prasad ML, Orsay CP et al (1985) Early local complications from intestinal stomas. Arch Surg 120:1145–1147

    PubMed  CAS  Google Scholar 

  11. Sjodahl R, Anderberg B, Bolin T (1988) Parastomal hernia in relation to site of the abdominal stoma. Br J Surg 75:339–341

    Article  PubMed  CAS  Google Scholar 

  12. Baslev A (1973) Kolostomitilvaerelse. Ugeskr Laeger 135:2799–2804

    Google Scholar 

  13. Stelzner S, Hellmich G, Ludwig K (1999) Die versorgong der Parakolostomiehernie nach Sugarbaker. Zentralblatt für Chirurgi 124(Suppl 2):13–17

    Google Scholar 

  14. Makela JT, Turko PH, Laitenen ST (1997) Analysis of late stomal complications following ostomy surgery. Ann Chir Gynaecol 86:305–310

    PubMed  CAS  Google Scholar 

  15. Everingham L (1998) The parastomal hernia dilemma. World Counc Enterostomal Ther J 18:32–34

    Google Scholar 

  16. Tretbar L (1988) Kirurgi vid stomikomplikationer. Stomijournalen: nordisk tidskrift för stomi vård 2:10–11

    Google Scholar 

  17. Carne PW, Robertson GM, Frizelle FA (2003) Parastomal hernia. Br J Surg 90:784–793

    Article  PubMed  CAS  Google Scholar 

  18. Israelsson LA (2008) Parastomal hernias. Surg Clin North Am 88:113–125

    Article  PubMed  Google Scholar 

  19. Williams JG, Etherington R, Hayward MW, Hughes LE (1990) Paraileostomy hernia: a clinical and radiological study. Br J Surg 77:1355–1357

    Article  PubMed  CAS  Google Scholar 

  20. Kronborg O, Kramhohft J, Backer O, Sprechler M (1974) Late complications following operations for cancer of the rectum and anus. Dis Colon Rectum 17:750–753

    Article  PubMed  CAS  Google Scholar 

  21. Martin L, Foster G (1996) Parastomal hernia. Ann R Coll Surg Engl 78:81–84

    PubMed  CAS  Google Scholar 

  22. Rubin MS, Schoetz DJ Jr, Matthews JB (1994) Parastomal hernia. Is stoma relocation superior to fascial repair? Arch Surg 129:413–419

    PubMed  CAS  Google Scholar 

  23. Kasperk R, Klinge U, Schumpelick V (2000) The repair of large parastomal hernias using a midline approach and a prosthetic mesh in the sublay position. Am J Surg 179:186–188

    Article  PubMed  CAS  Google Scholar 

  24. Stephenson BM, Phillips RK (1995) Parastomal hernia: local resiting and mesh repair. Br J Surg 82:1395–1396

    Article  PubMed  CAS  Google Scholar 

  25. Amin SN, Armitage NC, Abercrombie JF, Scholefield JH (2001) Lateral repair of parastomal hernia. Ann R Coll Surg Engl 83:206–208

    PubMed  CAS  Google Scholar 

  26. Janes A, Cengiz Y, Israelsson LA (2004) Preventing parastomal hernia with a prosthetic mesh. Arch Surg 139:1356–1358

    Article  PubMed  Google Scholar 

  27. Janes A, Cengiz Y, Israelsson LA (2004) Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia. Br J Surg 91:280–282

    Article  PubMed  CAS  Google Scholar 

  28. Berger (2007) Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal only mesh. Hernia 12:243–246

  29. Gögenur IM, Janni HT, Rosenberg J, Fischer A (2006) Prevention of parastomal hernia by placement of a polypropylene mesh at the primary operation. Dis Colon Rectum 49:1131–1135

    Article  PubMed  Google Scholar 

  30. Marimuthu K, Vijayasekar C, Ghosh D, Mathew G (2006) Prevention of parastomal hernia using preperitoneal mesh: a prospective observational study. Colorectal Dis 8:672–675

    Article  PubMed  CAS  Google Scholar 

  31. Cengiz Y, Israelsson LA (1998) Incisional hernias in midline incisions: an eight-year follow-up. Hernia 2:175–177

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Kirurgkliniken, Sundsvalls sjukhus, 851 86, Sundsvall, Sweden

    Arthur Jänes & Yucel Cengiz

  2. Department of Surgery and Perioperative Science, Umeå University, Umeå, Sweden

    Leif A. Israelsson

Authors
  1. Arthur Jänes
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  2. Yucel Cengiz
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  3. Leif A. Israelsson
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Corresponding author

Correspondence to Arthur Jänes.

Additional information

Leif A. Israelsson is a Consultant for Ethicon Innovation Group Worldwide.

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Jänes, A., Cengiz, Y. & Israelsson, L.A. Preventing Parastomal Hernia with a Prosthetic Mesh: A 5-Year Follow-up of a Randomized Study. World J Surg 33, 118–121 (2009). https://doi.org/10.1007/s00268-008-9785-4

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  • DOI: https://doi.org/10.1007/s00268-008-9785-4

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