Parastomal Hernia Prevention With Mesh in the Context of Laparoscopic Approach: An Opinion Based on Current Literature

López-Cano, Manuel; Rodríguez, José Antonio Pereira

doi:10.3389/fsurg.2018.00019

Cited by 4 publications

(8 citation statements)

References 30 publications

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“…Interest in hernia surgery is increasing worldwide, with focus not only on treatment but also on prevention (by laparoscopy or an open approach) [16,20]. Previous data from randomized clinical trials and meta-analyses confirm the safety, efficacy and cost-effectiveness of PSH prevention with a permanent synthetic mesh when creating an end-colostomy [3,17,20-22,25-,28].…”

Section: Discussionmentioning

confidence: 99%

“…According to a recent survey among surgeons of the European Society of Coloproctology, the application of prophylactic meshes is still very low, with only 10% of surgeons reporting routine prophylaxis . There are few studies in the literature that relate PSH to a specific technique such as APR . Even though there is solid evidence to support this policy, the clinical results must be audited, and the complications arising from this procedure must be comprehensively reported .…”

Section: Discussionmentioning

confidence: 99%

“…The rate of recurrence of PSH is about 70% after a repair with primary suture and 20% with a PSM [10,[12][13][14]. Moreover, PSH repair is technically difficult and is associated with higher morbidity than prevention using a prophylactic PSM at the initial procedure [15,16].…”

Section: Introductionmentioning

confidence: 99%

“…High-quality clinical evidence shows that the placement of a prophylactic PSM when performing a PEC (open or laparoscopic) reduces the incidence of PSH and the risk of subsequent repairs without increasing infectious complications [16][17][18][19][20][21]. However, a recent multicentre randomized trial found that the use of a prophylactic PSM did not improve the rate of PSH after permanent colostomy [22].…”

Section: Introductionmentioning

confidence: 99%

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Prevention of parastomal hernia after abdominoperineal excision with a prophylactic three‐dimensional funnel mesh

et al. 2019

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Aim A prophylactic three‐dimensional (3D) funnel mesh using the keyhole technique (intraperitoneal onlay mesh position) in abdominoperineal excision (APR) may significantly decrease the parastomal hernia (PSH) index without increasing morbidity. The aim of this retrospective observational study was to analyse the incidence of PSH and postoperative complications in patients who underwent permanent colostomy with the use of a prophylactic 3D preformed mesh compared with patients without a mesh. Method Patients who underwent an end‐colostomy after APR for primary or recurrent rectal cancer in a colorectal surgery unit were divided into two groups: group 1 without a prophylactic mesh and group 2 with a prophylactic synthetic mesh. The main end‐point was to analyse the incidence of PSH after a median follow‐up of 2.8 years. Results One hundred and ten patients (64 in group 1 and 46 in group 2, without significant clinical differences) underwent a permanent colostomy after APR. In group 1 70.3% developed a PSH, compared with 13% in group 2 (P < 0.001). Age (especially for patients ≥ 75 years) represented a significant risk factor for PSH. There were no differences in postoperative complications between the groups. Conclusion A prophylactic parastomal 3D mesh using the keyhole technique may reduce the incidence of PSH after permanent colostomy without an increase in postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevention of parastomal hernia after abdominoperineal excision with a prophylactic three‐dimensional funnel mesh

et al. 2019

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“…Most of the procedures, however, were performed before mesh reinforcement became routine. Over the last decade, a large number of studies on mesh reinforcement have been published, with conflicting results [31][32][33][34][35][36]. In a Cochrane review based on 10 studies, the risk for stomal hernia was found to be halved if the stoma is reinforced with a mesh [37].…”

Section: Discussionmentioning

confidence: 99%

Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Tivenius

Näsvall

Sandblom

2019

Int J Colorectal Dis

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Purpose Parastomal hernia is a complication with high morbidity that affects the patient's quality of life. The aim of this study was to assess the cumulative incidence of parastomal hernia in patients who have undergone colorectal cancer surgery and to identify potential risk factors that could predispose to the development of this type of hernia in a large population-based cohort over a long follow-up period. Methods The Swedish Colorectal Cancer Registry and the National Patient Register were used to collect study cohort data between January 2007 and September 2013. All patients undergoing colorectal cancer surgery including a permanent stoma were included in the study group. Results A total of 39,984 patients were registered during the study period. Of these, 7649 received a permanent stoma. Multivariate proportional hazard analysis, based on 6329 patients for whom all covariates could be retrieved, showed that the only independent risk factor for developing a parastomal hernia was BMI ≥ 30 (HR 1.49; 95% CI 1.02-2.17; p < 0.037). A slightly elevated hazard ratio was found for preoperative radiotherapy (HR 1.36; 95% CI 0.96-1.91; p < 0.070). The cumulative incidence of patients diagnosed or surgically treated for parastomal hernia over a follow-up period of 5 years was 7.7% (95% CI 6.1-9.2%). Conclusions The cumulative incidence of parastomal hernia causing symptoms or requiring surgery after 5 years was at least 7.7%. Obesity increases the risk of developing parastomal hernia.

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Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies

Frigault

Lemieux

Breton

et al. 2021

Hernia

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Parastomal Hernia Prevention With Mesh in the Context of Laparoscopic Approach: An Opinion Based on Current Literature

Cited by 4 publications

References 30 publications

Prevention of parastomal hernia after abdominoperineal excision with a prophylactic three‐dimensional funnel mesh

Prevention of parastomal hernia after abdominoperineal excision with a prophylactic three‐dimensional funnel mesh

Parastomal hernias causing symptoms or requiring surgical repair after colorectal cancer surgery—a national population-based cohort study

Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies

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