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BMC Surgery
Published in: BMC Surgery 1/2017

Open Access 01-12-2017 | Research article

Preventing parastomal hernias with systematic intraperitoneal specifically designed mesh

Authors: Raquel Conde-Muíño, José-Luis Díez, Alberto Martínez, Francisco Huertas, Inmaculada Segura, Pablo Palma

Published in: BMC Surgery | Issue 1/2017

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Abstract

Background

Parastomal 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.

Methods

Data 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.

Results

Thirty-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).

Conclusion

Prophylactic 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.
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Metadata
Title
Preventing parastomal hernias with systematic intraperitoneal specifically designed mesh
Authors
Raquel Conde-Muíño
José-Luis Díez
Alberto Martínez
Francisco Huertas
Inmaculada Segura
Pablo Palma
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2017
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-017-0237-7

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