Use of Prophylactic Mesh When Creating a Colostomy Does Not Prevent Parastomal Hernia

Abstract

The use of reinforcing mesh does not alter the rate of PSH. No difference in complication rate was seen between the 2 arms. Based on these results, the prophylactic use of mesh to prevent PSH cannot be recommended.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0.

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

“…Patient follow‐up of more than 1 year is essential for the correct assessment of PSH. In our series, the highest percentage of PSH occurs between the second and third year of follow‐up . During the first year of follow‐up, just one hernia was recorded in patients with PSM, but they may appear up to 5 years after surgery.…”

“…Interest in hernia surgery is increasing worldwide, with focus not only on treatment but also on prevention (by laparoscopy or an open approach) . 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 . A recently published multicentre randomized trial (the STOMAMESH trial) analysed the placement of a prophylactic synthetic mesh for prevention of PSH .…”

“…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 . A recently published multicentre randomized trial (the STOMAMESH trial) analysed the placement of a prophylactic synthetic mesh for prevention of PSH . It was concluded that a reinforcing mesh does not alter the incidence (clinical or radiological) of PSH (29% vs 30%, P = 0.866), so its use was not recommend.…”

Incidence, risk factors and prevention of stoma site incisional hernias: a systematic review and meta‐analysis

“…Case reports, reviews, letters, abstracts or comments were excluded. Studies were included if they met the Full-text articles excluded (n = 141) Non-English (2) No data on incidence (38) <16 years of age (18) No mention of follow-up (27) Abstract, letter, case series or comment (41) Full text not available (3) Abdominal wall trauma (9) Only data of midline hernia (3) Records excluded (n = 1266)…”

Prevention and treatment of parastomal hernia: a position statement on behalf of the Association of Coloproctology of Great Britain and Ireland

“…There are several options for diagnosing PSH which include clinical examination and imaging. Imaging Table 1 RCTs using mesh prophylaxis during stoma formation and those included during meta-analysis [41,42,44 modalities include CT or ultrasound and can be performed under different conditions, e.g. supine with the Valsalva manoeuvre or semi-prone.…”