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Is parastomal hernia repair with polypropylene mesh safe?
Scott R Steele1, Patrick Lee, Matthew J Martin
1General Surgery Service, Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA 98431, USA.
American Journal of Surgery
|May 3, 2003
Summary
Parastomal hernia repair using polypropylene mesh is safe and effective, with a high success rate even after recurrence. This study reviewed complications and outcomes in 58 patients.
Area of Science:
- Surgical innovation and patient outcomes
- Gastrointestinal surgery and reconstructive procedures
Background:
- Growing concerns regarding polypropylene mesh safety in parastomal hernia repair have prompted re-evaluation.
- This study investigates the complication rates and outcomes associated with polypropylene mesh use in these repairs.
Purpose of the Study:
- To assess the safety and efficacy of polypropylene mesh in parastomal hernia repair.
- To identify predictors of complications following parastomal hernia repair with polypropylene mesh.
Main Methods:
- A retrospective review of 58 patients undergoing parastomal hernia repair with polypropylene mesh between January 1988 and May 2002.
- Mesh placement involved positioning it either above or below the fascia after stoma creation.
- Multivariate analysis was employed to identify independent predictors of complications.
Main Results:
- The overall complication rate related to polypropylene mesh was 36%, with recurrence being the most common (26%).
- Younger age was significantly associated with increased complications (P=0.04), while cancer patients exhibited fewer complications (P=0.02).
- Recurrence occurred in 15 patients, with 7 undergoing successful repair, achieving an overall success rate of 86%.
Conclusions:
- Parastomal hernia repair utilizing polypropylene mesh demonstrates a safe and effective profile.
- The findings support the continued use of polypropylene mesh in parastomal hernia repair, despite potential complications.