Prophylactic onlay mesh placement to prevent parastomal hernia in patients undergoing abdominoperineal resection: A prospective comparative study a year follow-up, a single-center experience

Abstract

Introduction: The rate of parastomal hernia may be decreased by implanting mesh at the time of stoma creation. Theevidence was previously restricted to a small number of randomized controlled trials.Objective: The purpose of this study is to determine if simultaneous prophylactic mesh applied during the abdominoperinealresection (APR) has a preventative effect on parastomal hernia (PSH) incidence following APR of rectal cancer.Patients and Methods: 53 surgically resected rectal cancer patients were included in this study, and were divided intotwo groups: experimental group (receiving mesh, n=22) and control group (no mesh, n=31). Patients in the control groupunderwent a conventional end colostomy, but those in the experimental group received a polypropylene mesh put onlay inthe shape of a keyhole around the colon. 24 months was the median follow-up period. Cox regression analysis was used toexamine the differences in risk functions. The significance of differences across groups was examined using the PearsonChi and Fisher’s exact tests. SPSS version 23 (SPSS Inc., Chicago, IL, USA) was used for all analyses, and a statisticallysignificant value of 0.05 was used.Results: The postoperative incidence rate of PSH was significantly lower in the experimental (13.6%) group than inthe control group (45.2%) at 24 months follow-up, (P=0.015). The PSH operative time in the experimental group wassignificantly longer compared with the control group (265.95 min vs. 256.74 min; P=0.044). There is no significantdifference between both groups regarding stoma prolapse, stenosis and necrosis.Conclusion: Mesh prophylaxis appears secure and effective in preventing parastomal hernia at the time of stoma creationin APR patients.