Preventing parastomal hernias with systematic intraperitoneal specifically designed meshReport as inadecuate




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BMC Surgery

, 17:41

Visceral and general surgery

Abstract

BackgroundParastomal hernia is a very common complication after stoma formation. Current surgical techniques for repairing parastomal hernia have unsatisfactory results. We aim to assess our preliminary experience with prophylactic mesh placement at the time of stoma formation.

MethodsData were prospectively recorded. A specifically designed mesh made of polyvinyl fluoride with central conduit Dynamesh IPST® was fixed using an intra-peritoneal onlay technique. Safety was evaluated by means of surgical data and frequency of mesh-related complications, efficacy by the rate of parastomal hernias.

ResultsThirty-four patients were included in the study. Three of them died before a year of follow up not related to the stoma, so they were excluded. The other 31 patients 11 women and 20 men were prospectively followed up after different pathologies resulting in a permanent colostomy. Twelve months after surgery CT-Scan imaging revealed two 6.4% parastomal hernias, one of them already clinically suspected. During the follow up, 29% of the patients n = 9 developed another type of hernia incisional, inguinal or both. In five patients 16.1% a light stomal retraction of the otherwise slightly prominent ostomy was observed. Median clinical follow-up was 17.5 months range 12–34.

ConclusionProphylactic parastomal mesh placement might be a safe and effective procedure with a potential to reduce the risk of parastomal hernia. Routine use of this technique should be further analysed.

AbbreviationsBMIBody mass index

CT-scanComputed tomography scan

PSHParastomal hernia

PVDFPolyvinylidene Xuoride





Author: Raquel Conde-Muíño - José-Luis Díez - Alberto Martínez - Francisco Huertas - Inmaculada Segura - Pablo Palma

Source: https://link.springer.com/



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