Top

Published in:

01-06-2021 | Enterostomy | Original Article

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

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

Published in: Hernia | Issue 3/2021

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.

Carne PWG, Robertson GM, Frizelle FA (2003) Parastomal Hernia. Br J Surg 90(7):784–793. https://doi.org/10.1002/bjs.4220CrossRefPubMed

Klinge U, Binnebösel M, Rosch R (2006) Hernia recurrence as a problem of biology and collagen. J Mini Access Surg 1:151–154. https://doi.org/10.4103/0972-9941.27729CrossRef

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

Van Dijk SM, Timmermans L, Deerenberg EB et al (2015) Parastomal Hernia: impact on quality of life? World J Surg 39(10):2595–2601. https://doi.org/10.1007/s00268-015-3107-4CrossRefPubMed

Israelsson LA (2005) Preventing and treating parastomal Hernia. World J Surg 29(8):1086–1089. https://doi.org/10.1007/s00268-005-7973-zCrossRefPubMed

Antoniou SA, Agresta F, Garcia Alamino JM et al (2018) European Hernia society guidelines on prevention and treatment of parastomal hernias. Hernia 22(1):183–198. https://doi.org/10.1007/s10029-017-1697-5CrossRefPubMed

Hansson BME, Bleichrodt ARP, De Hingh AIH (2004) Laparoscopic parastomal hernia repair using a keyhole technique results in a high recurrence rate. Arch Surg. https://doi.org/10.1001/archsurg.139.12.1356CrossRef

Jänes A, Cengiz Y, Israelsson LA (2004a) Preventing parastomal hernia with a prosthetic mesh. Arch Surg 139:1356–1358. https://doi.org/10.1001/archsurg.139.12.1356CrossRefPubMed

López-Cano M, Brandsma HT, Bury K et al (2017) Prophylactic mesh to prevent parastomal hernia after end colostomy: a meta-analysis and trial sequential analysis. Hernia 21(2):177–189. https://doi.org/10.1007/s10029-016-1563-xCrossRefPubMed

10.

Chapman SJ, Wood B, Drake TM, Young N, Jayne DG (2017) Systematic review and meta-analysis of prophylactic mesh during primary stoma formation to prevent parastomal hernia. Dis Colon Rectum 60(1):107–115. https://doi.org/10.1097/DCR.0000000000000670CrossRefPubMed

11.

López-Cano M, Lozoya-Trujillo R, Quiroga S et al (2012) Use of a prosthetic mesh to prevent parastomal hernia during laparoscopic abdominoperineal resection: a randomized controlled trial. Hernia 16(6):661–667. https://doi.org/10.1007/s10029-012-0952-zCrossRefPubMed

12.

Cross AJ, Buchwald PL, Frizelle FA, Eglinton TW (2017) Meta-analysis of prophylactic mesh to prevent parastomal hernia. Br J Surg 104(3):179–186. https://doi.org/10.1002/bjs.10402CrossRefPubMed

13.

Lambrecht JR, Larsen SG, Reiertsen O, Vaktskjold A, Julsrud L, Flatmark K (2015) Prophylactic mesh at end-colostomy construction reduces parastomal hernia rate: a randomized trial. Color Dis 17(10):O191–O197. https://doi.org/10.1111/codi.13065CrossRef

14.

Patel SV, Zhang L, Chadi SA, Wexner SD (2017) Prophylactic mesh to prevent parastomal hernia: a meta-analysis of randomized controlled studies. Tech Coloproctol 21(1):5–13. https://doi.org/10.1007/s10151-016-1559-7CrossRefPubMed

15.

Brandsma HT, Hansson BME, Aufenacker TJ et al (2017) Prophylactic mesh placement during formation of an end-colostomy reduces the rate of parastomal hernia. Ann Surg 265(4):663–669. https://doi.org/10.1097/SLA.0000000000001903CrossRefPubMed

16.

Moore KP, Wong F, Gines P et al (2003) The management of ascites in cirrhosis: report on the consensus conference of the international Ascites Club. Hepatology 38(1):258–266. https://doi.org/10.1053/jhep.2003.50315CrossRefPubMed

17.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213. https://doi.org/10.1097/01.sla.0000133083.54934.aeCrossRefPubMedPubMedCentral

18.

Śmietański M, Szczepkowski M, Alexandre JA et al (2014) European Hernia society classification of parastomal Hernias. Hernia 18(1):1–6. https://doi.org/10.1007/s10029-013-1162-zCrossRefPubMed

19.

Cornille JB, Pathak S, Daniels IR, Smart NJ (2017) Prophylactic mesh use during primary stoma formation to prevent parastomal hernia. Ann R Coll Surg Engl 99(1):2–11. https://doi.org/10.1308/rcsann.2016.0186CrossRefPubMedPubMedCentral

20.

García-Alamino JM, López-Cano M, Kroese L, Helgstrand F, Muysoms F (2019) Quality assessment and risk of bias of systematic reviews of prophylactic mesh for parastomal hernia prevention using AMSTAR and ROBIS tools. World J Surg 43(12):3003–3012. https://doi.org/10.1007/s00268-019-05139-zCrossRefPubMed

21.

López-Borao J, Madrazo-González Z, Kreisler E, Biondo S (2019) Prevention of parastomal hernia after abdominoperineal excision with a prophylactic three-dimensional funnel mesh. Color Dis 21(11):1326–1334. https://doi.org/10.1111/codi.14738CrossRef

22.

Berger D (2008) Prevention of parastomal hernias by prophylactic use of a specially designed intraperitoneal onlay mesh (Dynamesh IPST^®). Hernia. https://doi.org/10.1007/s10029-007-0318-0CrossRefPubMed

23.

Conde-Muíño R, Díez JL, Martínez A, Huertas F, Segura I, Palma P (2017) Preventing parastomal hernias with systematic intraperitoneal specifically designed mesh. BMC Surg 17:1. https://doi.org/10.1186/s12893-017-0237-7CrossRef

24.

Vierimaa M, Klintrup K, Biancari F et al (2015) Prospective, randomized study on the use of a prosthetic mesh for prevention of parastomal hernia of permanent colostomy. Dis Colon Rectum 58(10):943–949. https://doi.org/10.1097/DCR.0000000000000443CrossRefPubMed

25.

Zhou Z, Bilkhu A, Anwar S (2017) The use of a composite synthetic mesh in the vicinity of bowel–For repair and prophylaxis of parastomal hernias. Does it increase the risk of short term infective complications? Int J Surg 45:67–71. https://doi.org/10.1016/j.ijsu.2017.07.077CrossRefPubMed

26.

Köhler G, Hofmann A, Lechner M et al (2016) Prevention of parastomal hernias with 3D funnel meshes in intraperitoneal onlay position by placement during initial stoma formation. Hernia 20(1):151–159. https://doi.org/10.1007/s10029-015-1380-7CrossRefPubMed

27.

Jones HG, Rees M, Aboumarzouk OM et al (2018) Prosthetic mesh placement for the prevention of parastomal herniation. Cochrane Database Syst Rev 18:7. https://doi.org/10.1002/14651858.CD008905.pub3CrossRef

28.

Odensten C, Strigård K, Rutegård J et al (2019) Use of prophylactic mesh when creating a colostomy does not prevent parastomal hernia: a randomized controlled Trial–STOMAMESH. Ann Surg 269(3):427–431. https://doi.org/10.1097/SLA.0000000000002542CrossRefPubMed

29.

Schug-Pass C, Lippert H, Köckerling F (2010) Primary mesh augmentation with fibrin glue for abdominal wall closure-investigations on a biomechanical model. Langenbeck’s Arch Surg 395(2):151–156. https://doi.org/10.1007/s00423-008-0453-9CrossRef

30.

Sohn YJ, Moon SM, Shin US, Jee SH (2012) Incidence and risk factors of parastomal hernia. J Korean Soc Coloproctol 28(5):241–246. https://doi.org/10.3393/jksc.2012.28.5.241CrossRefPubMedPubMedCentral

31.

Jänes A, Cengiz Y, Israelsson LA (2004b) Preventing parastomal hernia with a prosthetic mesh: a randomized study. Arch Surg 139(12):1356–1358. https://doi.org/10.1001/archsurg.139.12.1356CrossRefPubMed

Title: Permanent end-colostomy parastomal hernia prevention using a novel three-dimensional mesh
Authors: Camillo Leonardo Bertoglio
Marianna Maspero
Lorenzo Morini
Andrea Zironda
Bruno Domenico Alampi
Michele Mazzola
Carmelo Magistro
Pietro Carnevali
Giovanni Ferrari
Publication date: 01-06-2021
Publisher: Springer Paris
Keywords: Enterostomy
Dental Prophylaxis
Enterostomy
Colostomy
Parastomale Hernie
Published in: Hernia / Issue 3/2021
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-020-02326-z

At a glance: The STEP trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2021

Quality of life after laparoscopic trans-abdominal pre-peritoneal inguinal hernia repair: spinal vs general anesthesia

High recurrence rate of children’s inguinal hernia after percutaneous internal ring suturing: a single-center study

Diagnostic methods in parastomal hernia; research and clinical relevance

Comparing apples and oranges will not guide treatment the right way in umbilical hernia repair: use either level-1 evidence or guidelines

Emergency surgery of the abdominal wall hernias: risk factors that increase morbidity and mortality—a single-center experience

Umbilical hernia, epigastric hernia and diastasis recti: an open discussion