Parastomal hernia prevention with permanent mesh in end colostomy : failure with late follow-up of cohorts in three randomized trials
López Cano, Manuel ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitari Vall d'Hebron)
Adell-Trapé, Montse ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitari Vall d'Hebron)
Verdaguer-Tremolosa, M ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitari Vall d'Hebron)
Rodrigues-Gonçalves, V ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitari Vall d'Hebron)
Badia-Closa, Jesus ![ORCID Identifier](/img/uab/orcid.ico)
(Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Serra-Aracil, Xavier ![ORCID Identifier](/img/uab/orcid.ico)
(Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Universitat Autònoma de Barcelona
Date: |
2023 |
Abstract: |
Purpose: Short-term results have been reported regarding parastomal hernia (PH) prevention with a permanent mesh. Long-term results are scarce. The objective was to assess the long-term PH occurrence after a prophylactic synthetic non-absorbable mesh. Methods: Long-term data of three randomized controlled trials (RCTs) were collected. The primary outcome was the detection of PH based exclusively on a radiological diagnosis by computed tomography (CT) performed during the long-term follow-up. The Kaplan-Meier method was used for the comparison of time to diagnosis of PH according to the presence of mesh vs. no-mesh and the technique of mesh insertion: open retromuscular, laparoscopic keyhole, and laparoscopic modified Sugarbaker. Results: We studied 121 patients (87 men, median age 70 years), 82 (67. 8%) of which developed a PH. The median overall length of follow-up was 48. 5 months [interquartile range (IQR) 14. 4-104. 9], with a median time until PH diagnosis of 17. 7 months (IQR 9. 3-49. 0). The survival analysis did not show significant differences in the time to development of a PH according to the presence or absence of a prophylactic mesh neither in the overall study population (log-rank, P = 0. 094) nor in the groups of each technique of mesh insertion, although according to the surgical technique, a higher reduction in the appearance of PH for the open retromuscular technique was found (log-rank, P = 0. 001). Conclusion: In the long-term follow-up placement of a non-absorbable synthetic prophylactic mesh in the context of an elective end colostomy does not seem effective for preventing PH. |
Rights: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. ![Creative Commons](/img/licenses/by.ico) |
Language: |
Anglès |
Document: |
Article ; recerca ; Versió publicada |
Subject: |
Hernia ;
Mesh ;
Parastomal ;
Prevention |
Published in: |
Hernia, Vol. 27 Núm. 3 (june 2023) , p. 657-664, ISSN 1248-9204 |
DOI: 10.1007/s10029-023-02781-4
PMID: 36966221
The record appears in these collections:
Research literature >
UAB research groups literature >
Research Centres and Groups (research output) >
Health sciences and biosciences >
Parc Taulí Research and Innovation Institute (I3PTArticles >
Research articlesArticles >
Published articles
Record created 2024-06-14, last modified 2024-06-25