384212

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

Article

Last updated: 05 Jan 2025

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Abstract

Introduction: The rate of parastomal hernia may be decreased by implanting mesh at the time of stoma creation. The
evidence 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 abdominoperineal
resection (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 into
two groups: experimental group (receiving mesh, n=22) and control group (no mesh, n=31). Patients in the control group
underwent a conventional end colostomy, but those in the experimental group received a polypropylene mesh put onlay in
the shape of a keyhole around the colon. 24 months was the median follow-up period. Cox regression analysis was used to
examine the differences in risk functions. The significance of differences across groups was examined using the Pearson
Chi and Fisher's exact tests. SPSS version 23 (SPSS Inc., Chicago, IL, USA) was used for all analyses, and a statistically
significant value of 0.05 was used.
Results: The postoperative incidence rate of PSH was significantly lower in the experimental (13.6%) group than in
the control group (45.2%) at 24 months follow-up, (P=0.015). The PSH operative time in the experimental group was
significantly longer compared with the control group (265.95 min vs. 256.74 min; P=0.044). There is no significant
difference 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 creation
in APR patients.

DOI

10.21608/EJSUR.2024.293910.1092

Keywords

Abdominoperineal resection APR, parastomal hernia PSH, Rectal Cancer

Authors

First Name

Moustafa

Last Name

Emad

MiddleName

M.

Affiliation

Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Email

dr.moustafaemad@gmail.com

City

-

Orcid

-

First Name

Karim

Last Name

Fahmy

MiddleName

-

Affiliation

Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Email

karimfahmy84@gmail.com

City

-

Orcid

-

First Name

Kareem

Last Name

Kamel

MiddleName

Ahmed

Affiliation

Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Email

kareemkamel88@gmail.com

City

-

Orcid

-

Volume

43

Article Issue

4

Related Issue

50769

Issue Date

2024-10-01

Receive Date

2024-10-05

Publish Date

2024-10-01

Page Start

1,471

Page End

1,481

Print ISSN

1110-1121

Online ISSN

1687-7624

Link

https://ejsur.journals.ekb.eg/article_384212.html

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https://ejsur.journals.ekb.eg/service?article_code=384212

Order

384,212

Type

Original Article

Type Code

3,086

Publication Type

Journal

Publication Title

The Egyptian Journal of Surgery

Publication Link

https://ejsur.journals.ekb.eg/

MainTitle

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

Details

Type

Article

Created At

21 Dec 2024