Mp61-08 cost-Effectiveness of Prophylactic Mesh Placement for Prevention of Parastomal Hernia in Patients Undergoing Ileal Conduit Urinary Diversion for Bladder Cancer

Abstract

Figure) on the first postoperative CT were assessed to determine risk factors for PH.RESULTS: The median age and median BMI were 70 years (IQR 63-74.75) and 23.09 kg/m2 (IQR 20.4-24.64), respectively. PH was observed in 20 patients (10.3%) after a median follow-up of 25.5 months. Of the 20 patients, 3 were symptomatic and 2 underwent repair of the PH. The cumulative incidences were 3.6%, 10.1% and 15.1 % at 1 year, 2 years and 5 years after operation, respectively. The sex-adjusted BMI and DPRAM were significant risk factors for PH (p[0.0377,p<0.0001,respectively). The odds ratios for developing PH were 3.42 and 24.6 for BMI !22.89 kg/m2 and DPRAM !2.4 cm, respectively.CONCLUSIONS: The radiography-based incidence of PH in the current Japanese series was lower than reported incidences in American series (13.535.2%). Although most patients in the current series had low BMI, higher BMI was still significantly associated with the incidence of PH. Moreover, DPRAM was also significantly associated with the incidence, suggesting that the operative procedure for creation of the passage is critical for future development of PH.

Editorial Comment

“…Further, novel ex vivo modeling studies can suggest refinements of our surgical technique (eg, linear fascial incision, reinforcing purse-string suture) that may also warrant further study. 4…”