Use of a Mesh to Prevent Parastomal Hernia

Randomized, Controlled, Prospective Study of the Use of a Mesh to Prevent Parastomal Hernia

Randomized, controlled, prospective study of 54 patients receiving surgery for cancer of the lower third of the rectum with a permanent end colostomy. The aim of the study was to reduce parastomal hernia (PH) occurrence by implanting a lightweight mesh in the sublay position. Patients were followed up a) clinically and b) radiologically by means of abdominal CT. In the clinical follow-up, hernias were observed in four out of 27 patients (14.8%) in the study group and in eleven out of 27 (40.7%) in the control group (p=0.03). The implantation of the mesh reduces the appearance of PH, is well tolerated, and does not increase morbidity

Inclusion Criteria:

• patients scheduled for permanent end colostomy to treat cancer of the lower third of the rectum,
• Aged over 18,
• Charlson comorbidity index below 7
• Elective surgery
• Radical surgery

Exclusion Criteria:

• Loop colostomies,
• Emergency surgery,
• Body mass index above 35 kg/sq.m.,
• Palliative surgery,
• Hepatic cirrhosis,
• Severe COPD (requiring home oxygen treatment),
• Corticoid treatment