Prevention of Parastomal Hernia Using Pre-peritoneal Mesh - Long Term Outcome of a Prospective Study

Biswas, Ankita; Marimuthu, Kalimuthu; Mathew, George

doi:10.1080/00015458.2015.11681061

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…Moreover, mesh application did not cause pain at the stomal site [25, 27]. Our pooled results are consistent with the findings of some non-RCTs that showed promising outcomes with mesh placement at the time of colostomy formation and absence of an increase in the complication rate [38, 47]. Lee et al performed a cost effectiveness analysis and found that the cost was lower and the ability to prevent parastomal hernia was greater with prophylactic mesh application in patients who underwent permanent colostomy than with the conventional method [48].…”

Section: Discussionsupporting

confidence: 87%

Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis

Zhu

Yang

et al. 2016

Gastroenterology Research and Practice

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Background. Parastomal hernia is a common complication after stoma formation, especially in permanent colostomy. The present meta-analysis aimed to evaluate the effectiveness of prophylactic mesh application during permanent colostomy for preventing parastomal hernia. Methods. Randomized controlled trials comparing outcomes in patients who underwent colostomy with or without prophylactic mesh application were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Libraries. Results. This meta-analysis included 8 randomized controlled trials with 522 participants. Our pooled results showed that prophylactic mesh application (mesh group) reduced the incidence of clinically detected parastomal hernia (risk ratio [RR]: 0.22; 95% confidence interval [CI]: 0.13–0.38; P < 0.00001), radiologically detected parastomal hernia (RR: 0.62; 95% CI: 0.47–0.82; P = 0.0008), and surgical repair for herniation (RR: 0.34; 95% CI: 0.14–0.83; P = 0.02) when compared with conventional permanent colostomy formation (control group). The incidence of complications, including wound infection, peristomal infection, mesh infection, stomal necrosis and stenosis, stoma site pain, and fistula, was not higher in the mesh group than in the control group. Conclusions. Our meta-analysis demonstrated that prophylactic mesh application at the time of primary colostomy formation is a promising method for the prevention of parastomal herniation.

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Section: Discussionsupporting

confidence: 87%

Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis

Zhu

Yang

et al. 2016

Gastroenterology Research and Practice

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show abstract

“…Until now, the use of prosthetic mesh has not been widely accepted as a standard of preventive prosthetics in most surgical centers. I believe that the main reason is their lack of awareness of the almost inevitable development of parastomal hernia with long-term observation 56 . Prophylactic mesh placement has been shown to be effective in reducing the incidence of cPH and rPH based on randomized trials in patients undergoing colostomy surgery.…”

Section: Figure 4 Determining the Coordinates Of The Base Point Of The Ledmentioning

confidence: 99%