Preventing Parastomal Hernia with a Prosthetic Mesh: A Five Year Follow Up of a Randomised Study

Excerpt

Definitive colostomy formation has become less frequent during the last two decades since abdominoperineal resection can now be omitted in many patients with rectal cancer, and Hartmann’s operation for sigmoid diverticulitis is increasingly replaced by resection with primary anastomosis—with a loop ileostomy, if necessary. Nevertheless, there are still a number of patients who will receive a definitive colostomy due to different reasons. Long-term quality of life in those patients is significantly correlated to a “good” colostomy that comprises a proper localization in the abdominal wall, a non-impaired evacuation, and finally an easy management of the ostomy devices. While patients with a well functioning colostomy have few restrictions in their daily live, patients with ostomy problems may be heavily disturbed in their individual quality of life. Furthermore, patients with parastomal hernia often need additional ostomy devices, i.e. specially shaped faceplates, and repeated use of health care resources, both causing a significant increase of cost. …