Prevention of parastomal hernia in the emergency setting

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Aim: This study assessed safety and efficacy associated with hernia prophylaxis using a retromuscular slowly resorbable synthetic mesh for stoma reinforcement. Method: This was a cohort study with a historic reference group. The study took place in a high-volume surgical department. During a 2-year period (July 2012–July 2014), we included 109 patients undergoing emergency surgery with formation of ileostomy or colostomy. All patients received a retromuscular slowly resorbable synthetic mesh (TIGR®, Novus Scientific) at the stoma site. The reference group included 117 patients who underwent emergency stoma formation without a prophylactic mesh in the 2-year period prior to July 2012. The primary endpoint was effect on prevention of parastomal hernia within 1 year. Secondary endpoints were 30-day and 1-year complications including mortality. Results: The operative field was contaminated or dirty in 48% of the procedures. Operative time was significantly longer in the mesh group. The cumulative incidences of parastomal hernia at 1 year for the control and the mesh group were 8 and 7% (p = 0.424), respectively. The postoperative 30-day and 1-year rate of complications, reoperations and mortality were not different between the two groups. No patients underwent removal of the mesh and no clinical mesh infections were seen. Conclusion: Use of a resorbable synthetic mesh during emergency ostomy formation showed no significant preventive effect on formation of parastomal hernia after 1 year. Although surgery was often conducted in a severely contaminated field, the procedure was without significantly increased complication rate.

OriginalsprogEngelsk
TidsskriftLangenbeck's Archives of Surgery
Vol/bind402
Udgave nummer6
Sider (fra-til)949-955
Antal sider7
ISSN1435-2443
DOI
StatusUdgivet - 2017

ID: 196917318