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Randomized Controlled Trial Clinical Trial
Preventing parastomal hernia with a prosthetic mesh.
- Arthur Jänes, Yucel Cengiz, and Leif A Israelsson.
- Kirurgkliniken, Sundsvalls sjukhus, SE-851 86 Sundsvall, Sweden. arthur.janes@lvn.se
- Arch Surg Chicago. 2004 Dec 1; 139 (12): 1356-8.
HypothesisParastomal hernia is a common complication following colostomy. The lowest recurrence rate has been produced when repair is with a prosthetic mesh. This study evaluated the effect on stoma complications of using a mesh during the primary operation.DesignRandomized clinical study.MethodsPatients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. The mesh used was a large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material.ResultsTwenty-seven patients had a conventional stoma, and in 27 patients the mesh was used. No infection, fistula formation, or pain occurred (observation time, 12-38 months). At the 12-month follow-up, parastomal hernia was present in 13 of 26 patients without a mesh and in 1 of 21 patients in whom the mesh was used.ConclusionsA lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material placed in a sublay position at the stoma site is not associated with complications and significantly reduces the rate of parastomal hernia.
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