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Erschienen in: Hernia 3/2021

31.10.2020 | Original Article

Permanent end-colostomy parastomal hernia prevention using a novel three-dimensional mesh

verfasst von: Camillo Leonardo Bertoglio, Marianna Maspero, Lorenzo Morini, Andrea Zironda, Bruno Domenico Alampi, Michele Mazzola, Carmelo Magistro, Pietro Carnevali, Giovanni Ferrari

Erschienen in: Hernia | Ausgabe 3/2021

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Abstract

Purpose

Prophylactic mesh placement has been proposed to reduce the high occurrence of parastomal hernia (PSH) after stoma formation.

Methods

This is an observational study comparing two cohorts of patients: a mesh prophylaxis group (who received mesh prevention since introduction at our Institution) and a no mesh prophylaxis group (retrospectively selected from our historical series). Same exclusion criteria were applied for both groups. The study was conducted at a tertiary referral center for colorectal surgery. 43 patients were operated with mesh prophylaxis between May 2015 and may 2019. 45 patients underwent end-colostomy formation without prophylaxis between April 2011 and April 2015. The primary outcome measure was PSH development at 12-month follow up.

Results

Demographic variables and risk factors for PSH were comparable between the two groups. There was no difference between the two cohorts in terms of operative time and main early postoperative outcomes. 37 patients completed the 12-month follow up in each group. PSH occurrence after 12-months was 11% in the mesh prophylaxis group and 54% in the no mesh prophylaxis group (p < 0.0001). There were no differences in long-term complications. 5% of patients who received mesh prophylaxis underwent emergency surgery for bowel occlusion at 7 and 10 months after surgery, with partial or complete mesh removal. At multivariate analysis, mesh prophylaxis was a protective factor for PSH development at 12 months (p < 0.0001).

Conclusions

Prophylactic intraperitoneal mesh placement appears to be effective in preventing PSH.
Literatur
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Zurück zum Zitat Ripoche J, Basurko C, Fabbro-Perray P, Prudhomme M (2011) Éventrations péristomiales. Étude de la fédération des stomisés de France. J Chir Viscerale 148(6):493–500 Ripoche J, Basurko C, Fabbro-Perray P, Prudhomme M (2011) Éventrations péristomiales. Étude de la fédération des stomisés de France. J Chir Viscerale 148(6):493–500
Metadaten
Titel
Permanent end-colostomy parastomal hernia prevention using a novel three-dimensional mesh
verfasst von
Camillo Leonardo Bertoglio
Marianna Maspero
Lorenzo Morini
Andrea Zironda
Bruno Domenico Alampi
Michele Mazzola
Carmelo Magistro
Pietro Carnevali
Giovanni Ferrari
Publikationsdatum
31.10.2020
Verlag
Springer Paris
Erschienen in
Hernia / Ausgabe 3/2021
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-020-02326-z

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