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Prophylactic stoma mesh did not prevent parastomal hernias
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanlands Hosp Vasteras, Dept Surg, S-72189 Vasteras, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanlands Hosp Vasteras, Dept Surg, S-72189 Vasteras, Sweden..
Vastmanlands Hosp Vasteras, Dept Surg, S-72189 Vasteras, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanlands Hosp Vasteras, Dept Surg, S-72189 Vasteras, Sweden..
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2015 (English)In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 30, no 9, 1217-1222 p.Article in journal (Refereed) Published
Abstract [en]

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. 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. 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. 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.

Place, publisher, year, edition, pages
2015. Vol. 30, no 9, 1217-1222 p.
Keyword [en]
Parastomal hernia, Mesh, Surgery, Rectal cancer, Colostomy
National Category
Cancer and Oncology Surgery Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:uu:diva-262964DOI: 10.1007/s00384-015-2293-8ISI: 000360542000009PubMedID: 26099319OAI: oai:DiVA.org:uu-262964DiVA: diva2:856446
Available from: 2015-09-24 Created: 2015-09-23 Last updated: 2017-12-01Bibliographically approved

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Nikberg, MaziarSverrisson, IngvarChabok, AbbasSmedh, Kenneth

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