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Prophylactic Mesh Application during Colostomy to Prevent Parastomal Hernia: A Meta-Analysis
JunJia Zhu1, YuWei Pu1, XiaoDong Yang1
1Department of General Surgery, Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, China.
Gastroenterology Research and Practice
|November 8, 2016
Summary
Prophylactic mesh application during permanent colostomy significantly reduces parastomal hernia incidence. This surgical technique also lowers the need for hernia repair without increasing complications, offering a promising preventative measure.
Area of Science:
- Gastroenterology and Surgical Oncology
- Abdominal Wall Reconstruction
- Minimally Invasive Surgery
Background:
- Parastomal hernia is a frequent complication following colostomy, particularly permanent ones.
- Current management often involves surgical repair after hernia development.
- Preventative strategies are sought to mitigate this common morbidity.
Approach:
- A systematic meta-analysis was conducted, pooling data from 8 randomized controlled trials.
- PubMed, EMBASE, Science Citation Index, and Cochrane Libraries were searched for relevant studies.
- 522 participants undergoing permanent colostomy with or without prophylactic mesh were included.
Key Points:
- Prophylactic mesh significantly decreased clinically detected parastomal hernias (RR: 0.22) and radiologically detected hernias (RR: 0.62).
- Mesh use reduced the requirement for subsequent surgical repair of parastomal hernias (RR: 0.34).
- No significant increase in complications like wound infection, stomal issues, or pain was observed with mesh application.
Conclusions:
- Prophylactic mesh application during primary colostomy formation is an effective strategy for preventing parastomal hernias.
- This approach shows a favorable safety profile, with complication rates comparable to conventional methods.
- The findings support mesh use as a promising method to reduce parastomal hernia incidence.
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01:24Ostomy Care
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An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
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