Preventing parastomal hernias with systematic intraperitoneal specifically designed mesh

BMC Surgery

Research Article

Alberto Martínez¹  Raquel Conde-Muíño²  Pablo Palma²  Inmaculada Segura²  Francisco Huertas²  José-Luis Díez² 

[1] Department of Radiology, Complejo Hospitalario Universitario de Granada, Granada, Spain;Division of Colon & Rectal Surgery, Complejo Hospitalario Universitario de Granada, Granada, Spain;

关键词: Incisional Hernia;    Parastomal Hernia;    Imperforate Anus;    Stoma Formation;    Laparoscopic Incisional Hernia Repair;   

DOI  :  10.1186/s12893-017-0237-7

 received in 2016-06-21, accepted in 2017-04-06,  发布年份 2017

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s). 2017