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Frigault J, Lemieux S, Breton D, Bouchard P, Bouchard A, Grégoire RC, Letarte F, Bouchard G, Boun V, Massé K, Drolet S. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies. Hernia 2021; 26:495-506. [PMID: 34132954 DOI: 10.1007/s10029-021-02440-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Parastomal hernia (PSH) is the most common complication of stoma formation. The safety and efficiency of prophylactically placing mesh to prevent PSH remain controversial. To address this question, we examined the incidence of clinical and radiological PSH when using parastomal prophylactic mesh (PPM). METHODS We performed a retrospective, single-center, cohort study that included all patients with permanent stoma creation between 2015 and 2018. Patients were divided into two groups according to the utilization of PPM or not. RESULTS During the study period, 185 patients had a permanent stoma created, 144 with colostomy and 41 with ileostomy. PPM was placed in 79 patients. There was no difference in the need for early surgical reintervention (p = 0.652) or rehospitalization (p = 0.314) for stoma-related complications in patients with mesh as compared with patients without. Similarly, there was no difference in operative time (p = 0.782) or in length of hospital stay (p = 0.806). No patients experienced infection of the mesh or required prosthesis removal. There was a lower incidence rate of PSH with PPM placement in patients with permanent colostomy [adjusted hazard ratio (HR) 0.50 (95% confidence interval 0.28-0.89); p = 0.018]. In contrast, a higher incidence rate of PSH was observed in patients with ileostomy and PPM [adjusted HR 5.92 (95% confidence interval 1.07-32.65); p = 0.041]. CONCLUSION Parastomal prophylactic mesh placement to prevent PSH is a safe and efficient approach to reduce the incidence of PSH in patients requiring a permanent colostomy. However, mesh may increase the rate of PSH after permanent ileostomy.
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Affiliation(s)
- Jonathan Frigault
- Surgery Department, CHU de Quebec-Laval University, 1050 Avenue de la Médecine, Quebec, QC, Canada.
| | - Simon Lemieux
- Radiology and Nuclear Medicine Department, CHU de Quebec-Laval University, Quebec, Canada
| | - Dominic Breton
- Radiology and Nuclear Medicine Department, CHU de Quebec-Laval University, Quebec, Canada
| | - Philippe Bouchard
- Surgery Department, CHU de Quebec-Laval University, 1050 Avenue de la Médecine, Quebec, QC, Canada
| | - Alexandre Bouchard
- Surgery Department, CHU de Quebec-Laval University, 1050 Avenue de la Médecine, Quebec, QC, Canada
| | - Roger C Grégoire
- Surgery Department, CHU de Quebec-Laval University, 1050 Avenue de la Médecine, Quebec, QC, Canada
| | - François Letarte
- Surgery Department, CHU de Quebec-Laval University, 1050 Avenue de la Médecine, Quebec, QC, Canada
| | - Gilles Bouchard
- Radiology and Nuclear Medicine Department, CHU de Quebec-Laval University, Quebec, Canada
| | | | | | - Sébastien Drolet
- Surgery Department, CHU de Quebec-Laval University, 1050 Avenue de la Médecine, Quebec, QC, Canada
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Dalela D, Palma-Zamora I, Rogers C. Re: Fredrick Leidberg, Petter Kollberg, Marie Allerbo, et al. Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh: A Randomised Study. Eur Urol 2020;78:757-63. Eur Urol 2021; 79:e115-e116. [PMID: 33487478 DOI: 10.1016/j.eururo.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Deepansh Dalela
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
| | | | - Craig Rogers
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
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Liedberg F, Kollberg P, Allerbo M, Baseckas G, Brändstedt J, Gudjonsson S, Hagberg O, Håkansson U, Jerlström T, Löfgren A, Patschan O, Sörenby A, Bläckberg M. Reply to Alireza Ghoreifi and Hooman Djaladat's Letter to the Editor re: Fredrik Liedberg, Petter Kollberg, Marie Allerbo, et al. Preventing Parastomal Hernia After Ileal Conduit by the Use of a Prophylactic Mesh: A Randomised Study. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2020.07.033. Eur Urol 2020; 78:e186-e187. [PMID: 32950295 DOI: 10.1016/j.eururo.2020.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Fredrik Liedberg
- Institute of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
| | - Petter Kollberg
- Institute of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden; Department of Urology, Helsingborg County Hospital, Helsingborg, Sweden
| | - Marie Allerbo
- Department of Urology, Helsingborg County Hospital, Helsingborg, Sweden
| | - Gediminas Baseckas
- Institute of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Johan Brändstedt
- Institute of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden
| | | | - Oskar Hagberg
- Institute of Translational Medicine, Lund University, Malmö, Sweden; Regional Cancer Centre South, Lund, Sweden
| | - Ulf Håkansson
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Tomas Jerlström
- Department of Urology, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Annica Löfgren
- Institute of Translational Medicine, Lund University, Malmö, Sweden
| | - Oliver Patschan
- Institute of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Anne Sörenby
- Institute of Translational Medicine, Lund University, Malmö, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Mats Bläckberg
- Department of Urology, Helsingborg County Hospital, Helsingborg, Sweden
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