Related Experiment Video
Updated: Jun 15, 2025
10:52
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
5.2K
Parastomal Hernia Prevention Using Funnel-Shaped Intra-Abdominal Mesh Compared to No Mesh: The Chimney Randomized
Elisa Mäkäräinen1, Heikki Wiik1, Maziar Nikberg2
1Oulu University Hospital, Medical Research Center Oulu, Oulu, Finland.
JAMA Surgery
|August 28, 2024
Summary
A funnel-shaped parastomal mesh significantly reduced parastomal hernias in patients undergoing rectal cancer surgery. This mesh is a safe and effective option for preventing parastomal hernias.
Area of Science:
- Colorectal Surgery
- Hernia Prevention
- Surgical Innovation
Background:
- Parastomal hernias are a common complication after ostomy creation.
- Prophylactic mesh placement is debated due to conflicting evidence.
Purpose of the Study:
- To evaluate the efficacy and safety of a funnel-shaped permanent synthetic parastomal mesh in preventing parastomal hernias.
Main Methods:
- A randomized, single-blinded, multicenter trial (Chimney Trial) involving 135 patients undergoing abdominoperineal resection or Hartmann procedure.
- Comparison of a funnel-shaped intraperitoneal mesh group versus a control group without mesh.
- Primary endpoint: CT-confirmed parastomal hernia incidence at 12 months.
Main Results:
- The mesh group showed a significantly lower rate of CT-confirmed parastomal hernia (10% vs. 37%, P<.001).
- Clinical parastomal hernia rates were also significantly lower in the mesh group (2% vs. 43%, P<.001).
- Increased ileus rates (Clavien-Dindo class II) were observed in the mesh group (35% vs. 17%, P=.006).
Conclusions:
- Funnel-shaped parastomal mesh effectively prevents parastomal hernias.
- The mesh did not increase other stoma-related complications, reoperations, or negatively impact quality of life.
- This mesh represents a feasible option for parastomal hernia prevention.
