Prophylactic stoma mesh did not prevent parastomal hernias.
Int J Colorectal Dis
; 30(9): 1217-22, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-26099319
ABSTRACT
PURPOSE:
Parastomal herniation is reported in up to 50 % of patients with a colostomy. A prophylactic stoma mesh has been reported to reduce parastomal hernia rates. The aim of the study was to evaluate the rate of parastomal hernias in a population-based cohort of patients, operated with and without a prophylactic mesh at two different time periods.METHODS:
All rectal cancer patients operated with an abdominoperineal excision or Hartmann's procedure between 1996 and 2012 were included. From 2007, a prophylactic stoma mesh was placed in the retro-muscular plane. Patients were followed prospectively with clinical and computed tomography examinations.RESULTS:
There were no differences with regard to age, gender, pre-operative albumin levels, ASA score, body mass index (BMI), smoking or type of surgical resection between patients with (n = 71) and without a stoma mesh (n = 135). After a minimum follow-up of 1 year, 187 (91%) of the patients were alive and available for analysis. At clinical and computed tomography examinations, exactly the same parastomal hernia rates were found in the two groups, viz, 25 and 53%, respectively (p = 0.95 and p = 0.18). The hernia sac contained omentum or intestinal loops in 26 (81%) versus 26 (60%) patients with and without a mesh, respectively (p = 0.155). In the multivariate analyses, high BMI was associated with parastomal hernia formation.CONCLUSIONS:
A prophylactic stoma mesh did not reduce the rate of clinically or computed tomography-verified parastomal hernias. High BMI was associated with an increased risk of parastomal hernia formation regardless of prophylactic stoma mesh.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
/
Telas Cirúrgicas
/
Colostomia
/
Hérnia Abdominal
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article