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Systematic Review of the Use of a Mesh to Prevent Parastomal Hernia

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Abstract

Background

Parastomal hernia is a major complication after stoma placement. Surgical procedures for repairing parastomal hernia are difficult and their failure rate is high. The use of a mesh implanted at the primary operation has shown promising results. Therefore, we performed a systematic review of the literature to evaluate the results of the placement of mesh at the time of stoma formation with the aim of preventing parastomal hernia.

Methods

The Medline, Embase, and Cochrane Library databases were searched using the keywords “parastomal or paracolostomy hernia.” Data regarding the incidence of hernia, the operative parameters, including mesh placement and types, and complications, including infection, stoma necrosis, and stenosis, were used and analyzed to evaluate the use of prophylactic mesh at the time of stoma formation.

Results

Three randomized controlled trials, three prospective observational series, and one retrospective study were selected and summarized. During the follow-up period (observation time of 1–83 months), parastomal hernia was present in 32/58 patients (55%) who did not have mesh placement and in 14/179 patients (7.82%) in whom mesh was used. Meta-analysis of three randomized controlled trials showed that prophylactic use of the mesh significantly diminished the incidence of parastomal hernia (p < 0.0001). Postoperative morbidity levels were similar whether the mesh was placed or not.

Conclusion

Prophylactic use of mesh at the time of stoma formation is a safe procedure and reduces the risk of parastomal hernia. For more detailed evaluation, additional large, double-blinded, randomized controlled trials with long-term follow-up are necessary.

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References

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  3. Birnbaum W, Ferrier P (1952) Complications of abdominal colostomy. Am J Surg 83:64–67

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  9. Shellito PC (1998) Complications of abdominal stoma surgery. Dis Colon Rectum 41:1562–1572

    Article  CAS  PubMed  Google Scholar 

  10. Burgess P, Matthew VV, Devlin HB (1984) A review of terminal colostomy complications following abdomino-perineal resection for carcinoma [abstract]. Br J Surg 71:1004

    Google Scholar 

  11. Rieger N, Moore J, Hewett P et al (2004) Parastomal hernia repair. Colorectal Dis 6:203–205

    Article  CAS  PubMed  Google Scholar 

  12. Baig MK, Larach JA, Chang S et al (2006) Outcome of parastomal hernia repair with and without midline laparotomy. Tech Coloproctol 10:282–286

    Article  CAS  PubMed  Google Scholar 

  13. Rubin MS, Schoetz DJ Jr, Matthews JB (1994) Parastomal hernia. Is stoma relocation superior to fascial repair? Arch Surg 129:413–418

    CAS  PubMed  Google Scholar 

  14. 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  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  16. Morris-Stiff G, Hughes LE (1998) The continuing challenge of parastomal hernia: failure of a novel polypropylene mesh repair. Ann R Coll Surg Engl 80:184–187

    CAS  PubMed  Google Scholar 

  17. LeBlanc KA, Bellanger DE, Whitaker JM et al (2005) Laparoscopic parastomal hernia repair. Hernia 9:140–144

    Article  CAS  PubMed  Google Scholar 

  18. Deol ZK, Shayani V (2003) Laparoscopic parastomal hernia repair. Arch Surg 138:203–205

    Article  PubMed  Google Scholar 

  19. Berger D, Bientzle M (2007) Laparoscopic repair of parastomal hernias: a single surgeon’s experience in 66 patients. Dis Colon Rectum 50:1668–1673

    Article  PubMed  Google Scholar 

  20. Craft RO, Huguet KL, McLemore EC et al (2008) Laparoscopic parastomal hernia repair. Hernia 12:137–140

    Article  CAS  PubMed  Google Scholar 

  21. Hansson BM, de Hingh IH, Bleichrodt RP (2007) Laparoscopic parastomal hernia repair is feasible and safe: early results of a prospective clinical study including 55 consecutive patients. Surg Endosc 21:989–993

    Article  CAS  PubMed  Google Scholar 

  22. Bayer I, Kyzer S, Chaimoff C (1986) A new approach to primary strengthening of colostomy with Marlex mesh to prevent paracolostomy hernia. Surg Gynecol Obstet 163:579–580

    CAS  PubMed  Google Scholar 

  23. 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  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  25. Serra-Aracil X, Bombardo-Junca J, Moreno-Matias J et al (2009) Randomized, controlled, prospective trial of the use of a mesh to prevent parastomal hernia. Ann Surg 249:583–587

    Article  PubMed  Google Scholar 

  26. Berger D (2008) Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST). Hernia 12:243–246

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  28. Ballas KD, Rafailidis SF, Symeonidis N et al (2010) Prevention of parastomal hernia. Is it possible? Ann Surg 251:385–386

    Article  PubMed  Google Scholar 

  29. Evans MD, Williams GL, Stephenson BM (2009) Preventing parastomal herniation: is prophylactic prosthetic mesh absolutely necessary? World J Surg 33:1538–1539

    Article  CAS  PubMed  Google Scholar 

  30. Schafer M (2009) Preventing parastomal hernia with a prosthetic mesh: a five-year follow-up of a randomised study. World J Surg 33:122–123

    Article  PubMed  Google Scholar 

  31. Ranger GS, Lovett B, Collier DS et al (2004) Letter 2: randomized clinical study of the use of a prosthetic mesh to prevent parastomal hernia (Br J Surg 2004; 91:280–282). Br J Surg 91:897

    Article  CAS  PubMed  Google Scholar 

  32. Miri B (2004) Letter 1: randomized clinical study of the use of a prosthetic mesh to prevent parastomal hernia (Br J Surg 2004; 91:280–282). Br J Surg 91:896–897

    Article  CAS  PubMed  Google Scholar 

  33. Tadeo-Ruiz G, Picazo-Yeste JS, Moreno-Sanz C et al (2010) Parastomal hernias: background, current status and future prospects. Cir Esp 87(6):339–349

    Article  PubMed  Google Scholar 

  34. Rosch R, Junge K, Bohm G et al (2008) Surgical treatment and prophylaxis of parastomal hernias. Zentralbl Chir 133:464–467

    Article  CAS  PubMed  Google Scholar 

  35. Helgstrand F, Gogenur I, Rosenberg J (2008) Prevention of parastomal hernia by the placement of a mesh at the primary operation. Hernia 12:577–582

    Article  CAS  PubMed  Google Scholar 

  36. Thompson MJ (2008) Parastomal hernia: incidence, prevention and treatment strategies. Br J Nurs 17:S16, S18–S20

    Google Scholar 

  37. Israelsson LA (2005) Preventing and treating parastomal hernia. World J Surg 29:1086–1089

    Article  PubMed  Google Scholar 

  38. Nagy A, Kovacs T, Bognar J et al (2004) Parastomal hernia repair and prevention with PHSL type mesh after abdomino-perineal rectum extirpation. Zentralbl Chir 129:149–152

    Article  CAS  PubMed  Google Scholar 

  39. Lopez-Cano M, Lozoya-Trujillo R, Espin-Basany E (2009) Prosthetic mesh in parastomal hernia prevention. Laparoscopic approach. Dis Colon Rectum 52:1006–1007

    PubMed  Google Scholar 

  40. Vijayasekar C, Marimuthu K, Jadhav V et al (2008) Parastomal hernia: Is prevention better than cure? Use of preperitoneal polypropylene mesh at the time of stoma formation. Tech Coloproctol 12:309–313

    Article  CAS  PubMed  Google Scholar 

  41. 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 49:1131–1135

    Article  PubMed  Google Scholar 

  42. Jänes 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 33:118–121

    Article  PubMed  Google Scholar 

  43. Hammond TM, Huang A, Prosser K et al (2008) Parastomal hernia prevention using a novel collagen implant: a randomised controlled phase 1 study. Hernia 12:475–481

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

Ka-Wai Tam, Po-Li Wei, Li-Jen Kuo, and Chih-Hsiung Wu have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei, 110, Taiwan

    Ka-Wai Tam, Po-Li Wei & Li-Jen Kuo

  2. Evidence-based Medicine Centre, Taipei Medical University Hospital, Taipei, Taiwan

    Ka-Wai Tam

  3. Division of General Surgery, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan

    Chih-Hsiung Wu

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  1. Ka-Wai Tam
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Correspondence to Ka-Wai Tam.

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Tam, KW., Wei, PL., Kuo, LJ. et al. Systematic Review of the Use of a Mesh to Prevent Parastomal Hernia. World J Surg 34, 2723–2729 (2010). https://doi.org/10.1007/s00268-010-0739-2

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  • DOI: https://doi.org/10.1007/s00268-010-0739-2

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