Role of Biological Mesh in Surgical Treatment of Paracolostomy Hernias

Abstract

BACKGROUND: Paracolostomy hernia is a frequent complication of intestinal stoma. Its correction can be made through relocation of the colostomy or by keeping it in place and performing abdominal wall reinforcement through direct suturing with or without a prosthesis. METHOD: Results of surgical treatment of paracolostomy hernias were analyzed in 22 patients who underwent surgery in our hospital during the past 15 years, with or without biological mesh (bovine pericardium). All patients had terminal colostomies after abdominoperineal excision of the rectum. RESULTS: In 15 (68.2%) patients, hernia correction was made by maintaining the colostomy in place, in 2 of them (9.1%) without reinforcement, and in the other 13 (59.1%) through reinforcement of the aponeurosis with biological mesh. In the 7 (31.8%) other patients, hernia correction was accomplished by relocation of the colostomy. The mean follow-up period was 50.2 months. Recurrence was observed in 3 (13.6%) patients after a median of 16 months post-correction. CONCLUSION: Paracolostomy hernia remains a surgical challenge due to its high recurrence rate. Primary repair using a prosthesis of biological material may be preferable since muscle-aponeurotic weakness is frequently observed.

Clinical Practice Guidelines for Ostomy Surgery

“…several small retrospective reviews of parastomal repairs using bioprosthetic materials for reinforcement have reported hernia recurrence rates between 7% and 27%. [118][119][120][121][122] however, follow-up in these studies was short (9-18 months). further comparative studies with longer follow-up are needed to establish the efficacy and cost-effectiveness of bioprosthetic materials in this setting.…”

Multicenter prospective randomized study comparing the technique of using a bovine pericardium biological prosthesis reinforcement in parietal herniorrhaphy (Tutomesh TUTOGEN) with simple parietal herniorrhaphy, in a potentially contaminated setting

“…The Tutomesh TUTOGEN prosthesis has been used for several years, and a number of publications have emphasized the use of this organic material (e.g., peristomal hernias, pediatric omphaloceles, sites where prosthetic contamination is almost systematic).…”

“…Tutomesh TUTOGEN (TUTOGEN Medical GmbH, Nümberg, Germany) is a bovine pericardium, noncrosslinked bioprosthesis whose use we tested in potentially contaminated areas (Image ).…”

Reconstruction of Abdominal Wall Defect with Composite Scaffold of 3D Printed ADM/PLA in a Rat Model

“…[2,3] These materials exhibit dense surface, so it is difficult for cells to grow smoothly into the interior of the scaffold; The pore diameter, void ratio, connectivity, and mechanical strength of its 3D spatial structure cannot be precisely adjusted as required. [4] The degradation rate of the non-crosslinked biomaterial scaffold is too fast, which can cause defect recurrence. [5] And most biological material originates from non-human species and non-abdominal walls and cannot accurately mimic the micro-environment of the abdominal wall tissue.…”