Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia

Br J Surg. 2004 Mar;91(3):280-2. doi: 10.1002/bjs.4417.

Abstract

Background: Parastomal hernia is a common complication following colostomy, and repair with a prosthetic mesh is associated with the lowest recurrence rate. The aim of this study was to determine the effect on stoma complications of using a mesh at the primary operation.

Methods: Patients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. A large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used.

Results: Twenty-seven patients were randomized to have a conventional stoma and 27 to have the mesh. No infection, fistula formation or pain occurred (observation time 2-28 months). At the 12-month follow-up, parastomal hernia was present in eight of 18 patients without a mesh and in none of 16 patients in whom the mesh was used.

Conclusion: A lightweight prosthetic mesh in a sublay position at the stoma site was not associated with infection or other early complications. Preliminary results indicate that the mesh prevented the development of parastomal hernia.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Colostomy*
  • Female
  • Follow-Up Studies
  • Hernia, Ventral / prevention & control*
  • Humans
  • Male
  • Polypropylenes / therapeutic use
  • Postoperative Complications / prevention & control*
  • Surgical Mesh*
  • Surgical Wound Infection / etiology

Substances

  • Polypropylenes