Prevention of parastomal hernia using preperitoneal mesh: a prospective observational study

Abstract

OBJECTIVE: Parastomal hernia is a common complication after stoma formation. The objective of the study was to see whether placing prophylactic preperitoneal mesh could reduce the incidence of parastomal hernia. METHOD: Patients having elective bowel surgery requiring permanent stoma were included in this study. The time required for mesh insertion, day of stoma function, and early complications were recorded. Follow up was at 6 weeks, 3-monthly for the first year and at 6-monthly intervals thereafter. RESULTS: Eighteen patients fulfilled the inclusion criteria and were followed up for 6-28 months (mean 16.05). The time taken for mesh placement was 12-22 min (mean 14). One patient had to have revision surgery on day 1 for stomal necrosis - the mesh was left in situ in that instance. This patient developed superficial laparotomy wound infection. During the follow up, no patients developed parastomal hernia, stomal prolapse, stenosis, retraction, fistula or obstruction. CONCLUSION: The early results, in this group of patients, show that prophylactic polypropylene mesh insertion at the time of permanent stoma formation is encouraging and long-term results are awaited.