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Preventing Parastomal Hernia With a Prosthetic Mesh
A Randomized Study
Arthur Jänes, MD;
Yucel Cengiz, MD, PhD;
Leif A. Israelsson, MD, PhD
Arch Surg. 2004;139:1356-1358.
Hypothesis Parastomal hernia is a common complication following colostomy. The lowest recurrence rate has been produced when repair is with a prosthetic mesh. This study evaluated the effect on stoma complications of using a mesh during the primary operation.
Design Randomized clinical study.
Methods Patients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. The mesh used was a large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material.
Results Twenty-seven patients had a conventional stoma, and in 27 patients the mesh was used. No infection, fistula formation, or pain occurred (observation time, 12-38 months). At the 12-month follow-up, parastomal hernia was present in 13 of 26 patients without a mesh and in 1 of 21 patients in whom the mesh was used.
Conclusions A lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material placed in a sublay position at the stoma site is not associated with complications and significantly reduces the rate of parastomal hernia.
Author Affiliations: Department of Surgery, Sundsvalls sjukhus, Sundsvall (Drs Jänes and Cengiz), and Department of Surgery and Perioperative Science, Umeå University, Umeå (Dr Israelsson), Sweden.
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