TY - JOUR

T1 - Prevention of parastomal hernia using mesh in patients undergoing rectum extirpation

AU - Trangbæk, Rune Munch

AU - Mynster, Tommie

N1 - Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

PY - 2019

Y1 - 2019

N2 - INTRODUCTION: Developing a parastomal hernia can lead to emergency surgery and cause discomfort. Placing a pro-phylactic mesh around the ostomy may potentially prevent hernias from developing. Randomised clinical trials and reviews have reported contradictory results from this prophylactic procedure with different rates of hernias and success. This descriptive cohort study aimed to investigate the rate of parastomal hernia after applying prophylactic mesh in patients undergoing surgery for rectal cancer.METHODS: In the period from 2010 to 2016, we included 133 patients who had a permanent colostomy with prophylactic mesh placement due to rectal cancer. The patients were seen in the ostomy ambulatory at least three times annually, and bulges and hernias were registered by a trained nurse. Computed tomography was used for verification of parastomal hernia. Data were registered retrospectively from patient files.RESULTS: After a median follow-up of 22 months, 24% of patients developed a parastomal hernia. Development of parastomal bulge without a subsequent hernia diagnosis was seen in 21%. The one-year rate of parastomal hernia was 9.7%.CONCLUSIONS: This cohort study supports the thesis of a low short-time rate of parastomal hernia in patients who had a prophylactic mesh placed during the ostomy formation and indicates that the rate of hernia increases over time after the first post-operative year.FUNDING: none.TRIAL REGISTRATION: not relevant.

AB - INTRODUCTION: Developing a parastomal hernia can lead to emergency surgery and cause discomfort. Placing a pro-phylactic mesh around the ostomy may potentially prevent hernias from developing. Randomised clinical trials and reviews have reported contradictory results from this prophylactic procedure with different rates of hernias and success. This descriptive cohort study aimed to investigate the rate of parastomal hernia after applying prophylactic mesh in patients undergoing surgery for rectal cancer.METHODS: In the period from 2010 to 2016, we included 133 patients who had a permanent colostomy with prophylactic mesh placement due to rectal cancer. The patients were seen in the ostomy ambulatory at least three times annually, and bulges and hernias were registered by a trained nurse. Computed tomography was used for verification of parastomal hernia. Data were registered retrospectively from patient files.RESULTS: After a median follow-up of 22 months, 24% of patients developed a parastomal hernia. Development of parastomal bulge without a subsequent hernia diagnosis was seen in 21%. The one-year rate of parastomal hernia was 9.7%.CONCLUSIONS: This cohort study supports the thesis of a low short-time rate of parastomal hernia in patients who had a prophylactic mesh placed during the ostomy formation and indicates that the rate of hernia increases over time after the first post-operative year.FUNDING: none.TRIAL REGISTRATION: not relevant.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Colostomy/adverse effects

KW - Female

KW - Follow-Up Studies

KW - Hernia, Ventral/epidemiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Peritoneum/surgery

KW - Postoperative Complications/epidemiology

KW - Prophylactic Surgical Procedures/instrumentation

KW - Rectal Neoplasms/surgery

KW - Retrospective Studies

KW - Surgical Mesh

KW - Tomography, X-Ray Computed

M3 - Journal article

C2 - 31256777

VL - 66

JO - Danish Medical Journal

JF - Danish Medical Journal

SN - 2245-1919

IS - 7

M1 - A5556

ER -